MedWorm: Ceftriaxone

  Antibiotic prescription patterns in hospitalized patients with nursing home-acquired pneumonia

Considerable research has increased our understanding of antibiotic prescribing practices in hospital settings when it comes to nosocomial pneumonia. Much less is known about the antibiotic prescribing patterns for hospitalized non-critically ill patients with nursing home-acquired pneumonia (NHAP).As part of a multisite quality improvement project, we sought to examine patterns of antibiotic prescription among healthcare providers as a function of underlying comorbid, functional, and clinical factors.Three tertiary care centers.Chart reviews of 397 individual admissions were performed on patients admitted from nursing homes with the diagnosis of pneumonia between January 2005 and September 2007.Compliance with national guidelines for the treatment of NHAP was poor. Overall, the 3 most com...

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  ROCEPHIN (Ceftriaxone Sodium) Injection, Powder, For Solution [Hoffmann-La Roche Inc]

Updated Date: Mar 15, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Various penA mutations together with mtrR, porB and ponA mutations in Neisseria gonorrhoeae isolates with reduced susceptibility to cefixime or ceftriaxone

Conclusions Reduced susceptibility of N. gonorrhoeae to ceftriaxone and cefixime was associated with diverse penA mutations, particularly PBP 2 pattern XIII containing an Ala-501->Val substitution, together with mtrR and porB mutations. The existence of only one strain having the mosaic penA sequence indicated that ceftriaxone and cefixime resistance in Korea is mostly not associated with a mosaic penA sequence. Highly heterogeneous NG-MAST sequence types excluded the clonal expansion of a particular subtype. (Source: Journal of Antimicrobial Chemotherapy)

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  Binding of ceftaroline to penicillin-binding proteins of Staphylococcus aureus and Streptococcus pneumoniae

Conclusions The high affinities of ceftaroline for MRSA PBP2a, MSSA PBPs 1–3 and S. pneumoniae PBP2x/2a/2b support the potential efficacy of ceftaroline in the treatment of infections caused by MRSA and S. pneumoniae. (Source: Journal of Antimicrobial Chemotherapy)

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  CEFTRIAXONE (Ceftriaxone Sodium) Injection, Powder, For Solution [BAXTER HEALTHCARE CORPORATION]

Updated Date: Mar 10, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Detection of pneumolysin and autolysin genes among antibiotic resistant

Conclusion: Emerging resistance observed for cefepime and ceftriaxone might be due their increased and frequent usage nowadays. Presence of pneumolysin appears to be more critical for pathogenesis of invasive infections than the ocular infections. However, presence of lytA gene in all the isolates signifies that irrespective of site of isolation, kind of infection caused, autolysin is an obligate necessity for this organism. (Source: Indian Journal of Medical Microbiology)

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  Lateral sinus thrombosis as a complication of acute mastoiditis in children

We have read with great interest the recent article by Christensen et al. , which presents important clinical observations for otogenic intracranial complications. It was a well-conducted study of lateral sinus thrombosis of otitis media in children. We would like to present some comments on this problem based on our experience and literature review. Authors presented seven cases of lateral sinus thrombosis (LST) in children as complications of acute otitis media (AOM)—four cases and chronic otitis media (COM)—three cases. LST is a rare intracranial complication of otitis media which contributes to lack of clear guidelines of how to manage this entity, i.e. the time of introduction of antibiotic therapy, whether to remove clot from the sinus or to ligate internal jugular vein (IJV), et...

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  Determination of an Inoculum Effect with Various Cephalosporins among Clinical Isolates of Methicillin-Susceptible Staphylococcus aureus.

Authors: Nannini EC, Stryjewski ME, Singh KV, Rude TH, Corey GR, Fowler VG, Murray BE Using 98 clinical MSSA isolates of known beta-lactamase (Bla) type, we found a pronounced inoculum effect for cephalexin (mostly Bla type A and C strains), mild for cephalothin (especially type B and C), and nonexistence for ceftriaxone and cefuroxime. Ceftobiprole showed the lowest MICs at high inoculum but with a slight increase for Bla-positive versus Bla-negative strains. Since a potential therapeutic effect associated with a cephalosporin inoculum effect has been described, further studies are warranted. PMID: 20211890 [PubMed - as supplied by publisher] (Source: Antimicrobial Agents and Chemotherapy)

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  Ceftriaxone plus gentamicin or ceftriaxone alone for streptococcal endocarditis in Japanese patients as alternative first-line therapies

This study included 31 patients who had definite or possible infectious endocarditis as defined by the modified Duke’s criteria Of these patients, 27 were treated with ceftriaxone plus gentamycin combination therapy and four with ceftriaxone monotherapy. Of these 31 cases, 29 had infections with Streptococcus species, and showed good responses to penicillin G and cefotaxime. Excluding one patient who died because of the underlying disease, all patients achieved clinical cure after treatment with either of the two regimens, showing no recurrence during a follow-up period of 6 months after completion of drug treatment. Although valve replacement was performed in 10 patients during the follow-up period, there were no recurrences in any of these patients 6 months postoperative...

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  Affinity of Ceftaroline and Other {beta}-Lactams for Penicillin-Binding Proteins from Staphylococcus aureus and Streptococcus pneumoniae.

Authors: Kosowska-Shick K, McGhee PL, Appelbaum PC We compared the affinity to all penicillin-binding proteins (PBPs) of ceftaroline with those of ceftriaxone and cefotaxime in 6 Staphylococcus aureus and 7 Streptococcus pneumoniae isolates of varying resistance phenotypes. Ceftaroline MICs were </=1 mug/ml against all S. aureus isolates, and were </=0.25 mug/ml for 4 of 7 isolates of S. pneumoniae. Ceftaroline affinities for penicillin-susceptible S. pneumoniae strain were PBP2X, 3 > 1A, 1B, 2A > 2B and ceftaroline had >/=4-fold higher IC50 (0.1-4 mug/ml) for PBP2X, 2A, 2B, and 3 compared to other cephalosporins tested. Among 3 penicillin-resistant S. pneumoniae strains, ceftaroline had high affinity to PBP2X (IC50 0.1-1 mug/ml), a primary target for cephalosporin PBP b...

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  Synergy of fosfomycin with other antibiotics for Gram-positive and Gram-negative bacteria

Conclusions  The synergistic combination of fosfomycin with other antibiotics may be a useful alternative treatment option for Gram-negative and Gram-positive infections. Additional studies using more stringent definitions of synergy, and studies reporting on the clinical efficacy of fosfomycin combinations in the current era of high antimicrobial resistance are needed. Content Type Journal ArticleCategory PharmacodynamicsDOI 10.1007/s00228-010-0794-5Authors Antonia C. Kastoris, Alfa Institute of Biomedical Sciences (AIBS) Athens GreecePetros I. Rafailidis, Alfa Institute of Biomedical Sciences (AIBS) Athens GreeceEvridiki K. Vouloumanou, Alfa Institute of Biomedical Sciences (AIBS) Athens GreeceIoannis D. Gkegkes, Alfa Institute of Biomedical Sciences (AIBS) Athens ...

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  International Nosocomial Infection Control Consortium (INICC) report, data summary for 2003-2008, issued June 2009

We report the results of the International Infection Control Consortium (INICC) surveillance study from January 2003 through December 2008 in 173 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study, using Centers for Disease Control and Prevention (CDC) US National Healthcare Safety Network (NHSN; formerly the National Nosocomial Infection Surveillance system [NNIS]) definitions for device-associated health care-associated infection, we collected prospective data from 155,358 patients hospitalized in the consortium's hospital ICUs for an aggregate of 923,624 days. Although device utilization in the developing countries' ICUs was remarkably similar to that reported from US ICUs in the CDC's NHSN, rates of device-associated nosocomial infection wer...

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  Characterization of CEM-101 Activity Against Gram-Positive Organisms.

Authors: Woosley LN, Castanheira M, Jones RN In vitro activity of CEM-101, a new fluoroketolide, was determined against Gram-positive organisms with various macrolide susceptibility profiles. Experiments for determination of MIC and MBC, timed-killing, single-step and multistep mutation rates, erythromycin induction of resistance, post-antibiotic effect (PAE) and drug interactions were performed for CEM-101 and results compared to telithromycin, macrolides and lincosamides. CEM-101 MBC results remained overall lower than those of telithromycin and CEM-101 displayed a two-fold greater potency compared the ketolide. Timed-killing curve testing resulted in CEM-101 having greater bactericidal activity than telithromycin (>/=3 log10 CFU/ml decrease of initial inoculum at 24 hours) for th...

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  Reproduction and Cancer Answers to Multiple Choice Questions for Vol. 24, No. 1

1.(a) T(b) F(c) T(d) F(e) T Streptococcus pyogenes typically lives in the throat or on the skin. The possibility of asymptomatic pharyngeal colonization has been amply demonstrated. The possibility of rectal colonization is not an explanation for resistance to penicillin derivatives. Failure of treatment with penicillin is generally attributed to other local commensal organisms producing β-lactamase. The use of parenteral ceftriaxone is indicated for the eradication of Gonococcus infection in older girls. In children the use of oral drugs is preferable. The use of a topical antibiotic is correct, but can be limited by the difficulty for the mother in inserting a cannula or catheter beyond the hymen. The age and the genital conformation of the girl are significant variables for this choic...

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  A multicentre, open-label, randomized comparative study of tigecycline versus ceftriaxone sodium plus metronidazole for the treatment of hospitalized subjects with complicated intra-abdominal infections

Clin Microbiol Infect Tigecycline (TGC) has demonstrated clinical efficacy and safety, in comparison with imipenem/cilastatin in phase 3 clinical trials, for complicated intra-abdominal infection (cIAI). The present study comprised a multicentre, open-label, randomized study of TGC vs. ceftriaxone plus metronidazole (CTX/MET) for the treatment of patients with cIAI. Eligible subjects were randomized (1:1) to receive either an initial dose of TGC (100 mg) followed by 50 mg every 12 h or CTX (2 g once daily) plus MET (1[ndash]2 g daily), for 4[ndash]14 days. The primary endpoint was the clinical response in the clinically evaluable (CE) population at the test of cure (TOC) assessment. Of 473 randomized subjects, 376 were CE. Among these, clinical cure rates were 70.4% (133/189) with TGC vs. ...

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  Antistaphylococcal activity of telavancin tested alone and in combination by time-kill assay.

ANTISTAPHYLOCOCCAL ACTIVITY OF TELAVANCIN TESTED ALONE AND IN COMBINATION BY TIME-KILL ASSAY. Antimicrob Agents Chemother. 2010 Feb 16; Authors: Lin G, Pankuch GA, Ednie LM, Appelbaum PC Synergy time-kill studies against 40 methicillin-resistant Staphylococcus aureus (MRSA) strains of differing resistance phenotypes were conducted. Subinhibitory concentrations of telavancin were combined with subMIC concentrations of other antimicrobial agents that might be used in combination with telavancin to provide Gram-negative coverage. The highest incidence of synergy was found after 24 h with gentamicin (90% of strains), followed by ceftriaxone (88%), rifampin and meropenem (each 65%), cefepime (45%), and ciprofloxacin (38%) for combinations tested at or below the intermediate breakpoi...

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  Ceftriaxone: Haemolysis leading to cerebral ischaemia in a child: case report

(Source: Reactions)

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  Ceftriaxone: Fatal anaphylactic shock during intradermal skin testing: case report

(Source: Reactions)

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  Cutaneous drug reaction with intravenous ceftriaxone

Kaur Inderpal, Singh JatinderIndian Journal of Pharmacology 2009 41(6):284-285 (Source: Indian Journal of Pharmacology)

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  Increased Clinical Failures When Treating Acute Otitis Media with Macrolides: A Meta-Analysis(March) (FREE).

CONCLUSIONS: The meta-analysis suggests that patients treated with macrolides for AOM may be more likely to have clinical failures. As such, it supports the current AAP AOM recommendation that macrolides be reserved for patients who can not receive amoxicillin or amoxicillin/clavulanate. PMID: 20150506 [PubMed - as supplied by publisher] (Source: The Annals of Pharmacotherapy)

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  Prosthetic hip joint infection with a Streptococcus agalactiae isolate not susceptible to penicillin G and ceftriaxone

(Source: Journal of Antimicrobial Chemotherapy)

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  Beta-lactam antibiotic reduces morphine analgesic tolerance in rats through GLT-1 transporter activation

Abstract: Glutamate transporter subtype 1 (GLT-1) activation is a promising – and understudied – approach for managing aspects of morphine tolerance caused by increased glutamatergic transmission. Identification of beta-lactam antibiotics as pharmaceuticals which activate GLT-1 transporters prompted us to hypothesize that repeated beta-lactam antibiotic (ceftriaxone) administration blocks development of tolerance to morphine antinociception through GLT-1 activation. Here, we injected rats with morphine (10mg/kg, s.c.) twice daily for 7 days to induce tolerance and used the hot-plate assay to determine antinociception on days 1, 4 and 7 of repeated morphine administration. Ceftriaxone and a selective GLT-1 transporter inhibitor dihydrokainate (DHK) were co-administered with morphine to ...

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  Agrobacterium radiobacter bacteremia in a child with acute lymphoblastic leukemia.

CONCLUSIONS: A. radiobacter is an emerging pathogen affecting immunocompromised children, particularly those with leukemia who carry central venous catheters. Although it has a low virulence, erratic susceptibility patterns, and high frequency of resistance to many antibiotics, ceftriaxone appears to be successful in treatment of most cases. Catheter removal for the clearance of bloodstream infections due to A. radiobacter may not be required in selected patients like the present case. PMID: 20127221 [PubMed - as supplied by publisher] (Source: World Journal of Pediatrics : WJP)

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  Dipyridamole and low doses of heparin as a new successful physiopathologic and therapeutic approach in 2 cases of disseminated intravascular coagulation.

Conclusion: Successful clinical recovery of 2 young patients with DIC with an unfavorable clinical evolution and a prognosis for a lethal outcome was achieved with the combination of a continuous infusion of dipyridamole and low doses of heparin. PMID: 20150041 [PubMed - in process] (Source: The Heart Surgery Forum)

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  High Prevalence of Mutations in Quinolone-resistance-determining Regions and mtrR Loci in Polyclonal Neisseria gonorrhoeae Isolates at a Tertiary Hospital in Southern Taiwan.

CONCLUSION: The high prevalence of multidrug resistance caused by varied resistance mechanisms in N. gonorrhoeae limits the drug choice. Ongoing surveillance of antimicrobial resistance and discovery of new effective antibiotic therapy are warranted in endemic areas. PMID: 20206836 [PubMed - as supplied by publisher] (Source: J Formos Med Assoc)

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  Med Sci Monit 2010; 16(2):CR84-91 "Bacterial colonization of pleural drains in patients with lung cancer: An analysis of risk factors"

Conclusions: Patients with resectable lung cancer showed a high rate of pleural drain colonization, mainly by opportunistic pathogens, even in the absence of clinical signs of infection. (Source: Medical Science Monitor)

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  Antibiotic treatment for bacterial meningitis caused by Listeria monocytogenes in a patient with multiple myeloma

In conclusion, meropenem is useful to treat bacterial meningitis caused by L. monocytogenes. This agent is indicated when ampicillin shows inadequate effect or if the patient has an allergy to ampicillin. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s10156-009-0014-3Authors Sadaya Matano, Tonami General Hospital Department of Hematology Tonami Toyama 939-1395 JapanShigehiko Satoh, Tonami General Hospital Department of Internal Medicine Tonami Toyama 939-1395 JapanYukari Harada, Tonami General Hospital Department of Internal Medicine Tonami Toyama 939-1395 JapanHajime Nagata, Tonami General Hospital Department of Clinical Laboratory Tonami Toyama 939-1395 JapanTatsuho Sugimoto, Tonami General Hospital Department of Internal Medicine Tonami Toyama 939-1395 Japan J...

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  Ceftriaxone: Haemolytic anaemia in a child: case report

(Source: Reactions)

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  In vitro activity of ceftaroline against 623 diverse strains of anaerobic bacteria.

Authors: Citron DM, Tyrrell KL, Merriam V, Goldstein EJ The in vitro activities of ceftaroline, a novel, parenteral, broad-spectrum cephalosporin, and 4 comparator antimicrobials were determined against anaerobic bacteria. Against gram-positive strains, the activity of ceftaroline was similar to that of amoxicillin/clavulanate and 4 to 8 times greater than ceftriaxone. Against gram-negative organisms, ceftaroline showed good activity against beta-lactamase-negative strains, but not against the Bacteroides fragilis group. Ceftaroline showed potent activity against a broad spectrum of anaerobes encountered in respiratory, skin, and soft-tissue infections. PMID: 20100877 [PubMed - as supplied by publisher] (Source: Antimicrobial Agents and Chemotherapy)

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  Nontypeable Haemophilus influenzae isolated from intractable acute otitis media internalized into cultured human epithelial cells

Conclusion: The potential of NTHi as the intracellular pathogen may contribute to the persistent existence of this pathogen that result in the prolonged and intractable clinical course of AOM. Azithromycin may be a therapeutically significant antibiotic for patients with prolonged respiratory tract infections due to NTHi. (Source: Auris, Nasus, Larynx)

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  Antibiograms and randomly amplified polymorphic DNA-polymerase chain reactions (RAPD-PCR) as epidemiological markers of gonorrhea

In this study, a total of 235 isolates of N. gonorrhoeae isolated from patients of Bangrak Hospital were tested for their antibiotic susceptibilities to penicillin, norfloxacin, ofloxacin, ciprofloxacin, spectinomycin, and ceftriaxone. Mutation (Ser-91) in the quinolone resistance determining regions of gyrA and random amplification of the polymorphic DNA polymerase chain reaction (RAPD-PCR) were examined from 145 isolates. Among these, 55 isolates were obtained during January-March 2000, 46 isolates during January-March 2002, and 44 isolates during October-December 2002. The occurrence of combination resistance between penicillin and quinolone was 20% in January-March 2000, which was increased to 57.8% during the period of October-December 2002 (P (Source: Journal of Clinical Laboratory A...

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  Evaluation of a Potential Clinical Interaction between Ceftriaxone and Calcium.

Authors: Steadman E, Raisch DW, Bennett CL, Esterly JS, Becker T, Postelnick M, McKoy JM, Trifilio S, Yarnold PR, Scheetz MH In April 2009 the FDA retracted a warning asserting that ceftriaxone and intravenous calcium products should not be co-administered in any patient to prevent precipitation events leading to end organ damage. Following this announcement, we sought to evaluate if the retraction was justified. A search of the FDA Adverse Event Reporting System was conducted to identify ceftriaxone/calcium interactions resulting serious adverse drug events. Ceftazidime/calcium was used as a comparator agent. One-hundred-four events with ceftriaxone/calcium and 99 events with ceftazidime/calcium were identified. Adverse drug events were recorded according to the listed description of ...

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  What are the Risks of Infertility after Pelvic Inflammatory Disease?

This study included patients 14-37 years but without subgroup analysis of adolescents. In another study, these researchers found that barrier methods (especially male condoms) significantly helped to prevent chronic pelvic pain, recurrent PID, and infertility. Questions for Further Discussion 1. What are the recommended treatment options for PID? 2. What are the recommendations for treating partners of patients with known PID and how are the partners contacted locally? 3. What are the legal requirements for treating minors with sexually transmitted infections? Related Cases Disease: Pelvic Inflammatory Disease | Chlamydia Infections Symptom/Presentation: Abdominal Pain | Pelvic Pain | Vaginal Discharge Specialty: Adolescent Medicine | Emergency Medicine | Infectious Diseases | Obstetrics...

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  Accidental induced seizures in three cynomologus macaques following administration of ceftriaxone dissolved in 1% lidocaine diluent

Following initial signs of dural infection, or as prophylactic postoperative therapy, three cynomologus macaques were given an intramuscular or a subcutaneous injection of ceftriaxone dissolved in a 1% lidocaine diluent (CL). Two to 15 min later, all three monkeys experienced a long-lasting generalized apnoeic clonic convulsive seizure. The injected doses of lidocaine (0.7–2 mg/kg) were as low as 7–20-fold less than the experimental intravenous dosage (14.2 ± 3.2 mg/kg) previously reported to induce seizure in healthy rhesus monkeys. Under different clinical conditions, the same three animals were either once (1 animal) or repeatedly given CL without any resultant neurological alterations. The monkeys had a cranial device implanted and two of them were craniotomized. Thi...

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  Fibrin ring granulomas in Rickettsia typhi infection

We describe a 71-year-old man hospitalized for fever and productive cough. Laboratory investigation showed anemia, thrombocytopenia, elevated transaminases, hyponatremia, and hypoalbuminemia. Computerized tomography of the abdomen, thorax, and sinuses, echocardiography, and a gallium scan did not reveal the source of the fever. The patient remained febrile despite courses of piperacillin–tazobactam/azithromycin and ceftriaxone/vancomycin. A bone marrow biopsy showed fibrin ring granulomas, and 2 rickettsial serologic panels were positive for Rickettsia typhi infection and negative for Q fever. The patient was given doxycycline, and the fever resolved within 48 h. We propose that fibrin ring granulomas also occur in murine typhus. (Source: Diagnostic Microbiology and Infectious Disease)

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  Attenuation of cerebrospinal fluid inflammation by the non-bacteriolytic antibiotic daptomycin vs ceftriaxone in experimental pneumococcal meningitis.

Authors: Denis G, Oberson K, Bühlmann A, Gäumann R, Leib SL Antibiotica-induced bacteriolysis exacerbates inflammation and brain damage in bacterial meningitis. Here the quality and the temporal kinetic of the cerebrospinal fluid (CSF) inflammation was assessed in an infant rat pneumococcal meningitis model for the non-bacteriolytic antbiotioc daptomycin vs ceftriaxone. Daptomycin led to lower CSF concentrations of IL-1beta, IL-10, IL-18; MCP-1 and MIP-1alpha (p<0.05). In experimental pneumococcal meningitis, daptomycin vs ceftriaxone treatment resulted in more rapid bacterial killing, lower CSF inflammation and less brain damage. PMID: 20065062 [PubMed - as supplied by publisher] (Source: Antimicrobial Agents and Chemotherapy)

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  Surveillance and Correlation of Antibiotic Prescription and Gram-Negative Resistance in Singapore Hospitals.

In conclusion, our data demonstrated correlation between prescription of and gram-negative resistance to several but not all key antimicrobial agents in Singapore hospitals. In areas where gram-negative resistance is endemic and prescription of broad-spectrum antimicrobial agents is high, factors other than antimicrobial usage may be equally important in maintaining high resistance rates. PMID: 20065055 [PubMed - as supplied by publisher] (Source: Antimicrobial Agents and Chemotherapy)

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  Acute epiglottitis: a retrospective review of 47 patients in Kuwait

Conclusion  In Kuwait, acute epiglottis is commoner in adults than in children. It is imperative to secure the airway and to start the patients on broad spectrum antibiotics and steroids as early as possible. In general, the prognosis is good with antimicrobial therapy, close monitoring and selective airway intervention, in the form of intubation / tracheostomy, for patients with stridor or shortness of breath. Content Type Journal ArticleCategory Main ArticleDOI 10.1007/s12070-009-0087-4Authors Imtiaz Majid Qazi, Zain and Al Sabah Hospitals Department of ENT P O Box 4078 Safat, Kuwait 13041 KuwaitAbdul Mohsin Jafar, Zain and Al Sabah Hospitals Department of ENT P O Box 4078 Safat, Kuwait 13041 KuwaitKhalid Al Abdul Hadi, Zain and Al Sabah Hospitals Department of ENT ...

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  Detection of pneumolysin and autolysin genes among antibiotic resistant <i>Streptococcus pneumoniae</i> in invasive infections

Conclusion:&lt;/b&gt; Emerging resistance observed for cefepime and ceftriaxone might be due their increased and frequent usage nowadays. Presence of pneumolysin appears to be more critical for pathogenesis of invasive infections than the ocular infections. However, presence of &lt;i&gt;lytA&lt;/i&gt; gene in all the isolates signifies that irrespective of site of isolation, kind of infection caused, autolysin is an obligate necessity for this organism. (Source: Indian Journal of Medical Microbiology)

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  Presence of Borrelia burgdorferi in endomyocardial biopsies in patients with new-onset unexplained dilated cardiomyopathy

In conclusion, Bb infection may represent an important cause of new-onset unexplained DCM in patients living in endemic regions such as the Czech Republic. Because the antibiotic treatment appears to be markedly effective and serological examination does not provide a tool for diagnosing the disease, EMB focused on the detection of Bb should be performed in all patients from endemic areas with new-onset unexplained DCM not responding to conventional therapy. Content Type Journal ArticleCategory Rapid CommunicationDOI 10.1007/s00430-009-0141-6Authors Tomas Palecek, Charles University of Prague 1st Medical Faculty, 2nd Medical Department - Clinical Department of Cardiology and Angiology Prague Czech RepublicPetr Kuchynka, Charles University of Prague 1st Medical Faculty, 2nd Medical...

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  Hearing Impairment in Childhood Bacterial Meningitis Is Little Relieved by Dexamethasone or Glycerol

CONCLUSIONS: With bacterial meningitis, the child's presenting status and young age are the most important predictors of hearing impairment. Little relief is obtained from current adjuvant medications. (Source: PEDIATRICS)

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  Prediction of incompatibility of ceftriaxone sodium with calcium ions using the ionic product.

Authors: Nakai Y, Tokuyama E, Yoshida M, Uchida T The purpose of this study was to evaluate the incompatibility of ceftriaxone sodium with calcium-containing products using the ionic product of precipitation, and the measurement of insoluble microparticles using a light obscuration particle counter. Appropriate volumes of 2% (w/v) calcium chloride solution were added to 0.4-2 mg/ml ceftriaxone isotonic sodium chloride solution, to make solutions with a final calcium ion concentration of 1.25 mmol/l. The solutions were gently agitated and stored at 37 degrees C for 24 h. The number of insoluble microparticles with a diameter less than 10 mum in the mixed sample solution, determined using a light obscuration particle counter, was increased when the ceftriaxone concentration was >0.8 m...

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  Influence of intralumenal and antibiotic-lock of vancomycin on the rate of catheter removal in the patients with permanent hemodialysis catheters.

This study was designed to evaluate the impact of the intraluminal vancomycin in comparison with intravenous antibiotic administration. We included 67 (37 males and 30 females) chronic HD patients requiring Permcath insertion at our tertiary care hospital from July 2004 to June 2007. We studied two subgroups: an intervention group, which received 500 mg vancomycin infusion via both lumens of the Permcath and antibiotic lock of 1.5 mL each 48 hours with 1 g i.v. ceftriaxone every 12 hours for 7 days, followed by oral antibiotics according to the culture for three weeks; and a control group, which received 500 mg intravenous vancomycin with daily 100-150 mg amikacin intravenously. Our endpoint was the rate of catheter removal. The patients characteristics including age, sex, time of insertio...

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  Ceftaroline Shows Promise In the Treatment of CAP

SAN FRANCISCO — Ceftaroline demonstrated a higher clinical cure rate, compared with ceftriaxone in patients hospitalized with community-acquired pneumonia, according to combined results from two phase III studies. (Source: Hospitalist News)

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  CEFTRIAXONE (Ceftriaxone Sodium) Injection, Solution [Baxter Healthcare Corporation]

Updated Date: Dec 31, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Genome-wide dissection of globally emergent multi-drug resistant serotype 19A Streptococcus pneumoniae

Conclusions: Our results suggest a complex genetic picture where high-level drug resistance, vaccine selection pressure, and SPN mutational events have created a "perfect storm" for the emergence of MDR 19A. (Source: BMC Genomics - Latest articles)

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  Are local clinical guidelines useful in promoting rational use of antibiotic prophylaxis in Caesarean delivery?

Conclusion In an attempt to ensure cost-effective prophylactic use of antibiotics in Caesarean delivery, local clinical guidelines were introduced. They resulted in changes in prescribing patterns of antibiotics. There was a significant decrease in use of ‘third’ generation of cephalosporin’s whereas the use of “older” antibiotics with proven efficacy and safety increased. In contrast, there was no significant change in treatment outcomes such as wound infection and average hospital stay. Content Type Journal ArticleCategory Research ArticleDOI 10.1007/s11096-009-9359-zAuthors Svetlana Ristić, University of Belgrade Clinic of Gynaecology and Obstetrics “Narodni front”, Medical School Belgrade SerbiaBranislava Miljković, University of Belgrade Department of Pharmacok...

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  ROCEPHIN (Ceftriaxone Sodium) Injection, Powder, For Solution [BAXTER HEALTHCARE CORPORATION]

Updated Date: Dec 29, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Modulation of Astrocyte Glutamate Transporters Decreases Seizures in a Mouse Model of Tuberous Sclerosis Complex.

Authors: Zeng LH, Bero AW, Zhang B, Holtzman DM, Wong M Astrocyte dysfunction may contribute to epileptogenesis and other neurological deficits in Tuberous Sclerosis Complex (TSC). In particular, decreased expression and function of astrocyte glutamate transporters have been implicated in causing elevated extracellular glutamate levels, neuronal death, and epilepsy in a mouse model of TSC (Tsc1(GFAP)CKO mice), involving inactivation of the Tsc1 gene primarily in astrocytes. Here, we tested whether pharmacological induction of astrocyte glutamate transporter expression can prevent the neurological phenotype of Tsc1(GFAP)CKO mice. Early treatment with ceftriaxone prior to the onset of epilepsy increased expression of astrocyte glutamate transporters, decreased extracellular glutamate lev...

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  The effect of routine vaccination on invasive pneumococcal infections in Canadian children, Immunization Monitoring Program, Active 2000-2007.

Authors: Bettinger JA, Scheifele DW, Kellner JD, Halperin SA, Vaudry W, Law B, Tyrrell G, Active surveillance was conducted by the 12 centers of the Canadian Immunization Monitoring Program, Active from 2000-2007 in children 16 years of age and younger to determine the influence of 7-valent pneumococcal conjugate immunization programs on the prevalence, serotype and antibiotic resistance patterns of invasive pneumococcal disease (IPD) caused by Streptococcus pneumoniae. The absolute number of reported IPD cases decreased 48% (p<0.01) over the 8-year period and 56% (p<0.01) in children 0-4 years of age. The absolute number of reported IPD cases caused by serotypes in the conjugate vaccine decreased 87.5% (p<0.01) overall and 92% (p<0.01) in children 0-4 years. Although 6 no...

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  Detection of VEB-1, OXA-10 and PER-1 genotypes in extended-spectrum β-lactamase-producing Pseudomonas aeruginosa strains isolated from burn patients

In conclusion, the high prevalence of multidrug resistance (87.05%) and production of OXA-10, PER-1 and VEB-1 genes in P. aeruginosa isolates in burn patients confirm that protocols considering these issues should be considered in burn hospitals. (Source: Burns : Journal of the International Society for Burn Injuries)

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  IV or Not IV? Just One of the Antibiotic Questions in Whipple's Disease

See “Efficacy of ceftriaxone or meropenem as initial therapies in Whipple's disease,” by Feurle GE, Junga NS, Marth T, on page 478. (Source: Gastroenterology)

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  An anti-nociceptive role for ceftriaxone in chronic neuropathic pain in rats

Abstract: Glial glutamate transporter-1 (GLT-1) plays an essential role in the maintenance of glutamate homeostasis and is involved in the development and maintenance of pathological pain. The present study was undertaken (1) to observe the anti-nociceptive effects of ceftriaxone (Cef) in a chronic neuropathic pain model induced by chronic constrictive nerve injury (CCI) of the sciatic nerve and (2) to identify the role of spinal GLT-1 in the process. CCI induced significant thermal hyperalgesia and mechanical allodynia, which began from postoperative day 3 and lasted to day 21. This long-term hyperalgesia was accompanied by significant down-regulation of GLT-1 expression in the L4–L6 segments of the spinal dorsal horn, as revealed by immunohistochemistry and Western blot. Intraperitonea...

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  Mimicry of lyme arthritis by synovial hemangioma

In conclusion, in children and adolescents synovial hemangioma has to be considered in differential diagnosis of recurrent knee swelling. Early diagnosis is important to prevent prolonged suffering from chronic joint swelling with probable joint damages, unnecessary treatment procedures and as well school and sports absenteeism. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s00296-009-1320-xAuthors Toni Hospach, Olgahospital, Klinikum Stuttgart Pediatric Rheumatology, Department of Pediatrics Bismarckstr. 8 70176 Stuttgart GermanyM. Langendörfer, Olgahospital, Klinikum Stuttgart Department of Orthopedic Surgery Stuttgart GermanyT. V. Kalle, Olgahospital, Klinikum Stuttgart Radiologic Clinic Stuttgart GermanyF. Tewald, Labor Prof. Enders Stuttgart GermanyT. Wirth, Olga...

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  Calcium/ceftriaxone interaction: Severe cardiopulmonary adverse events in infants: 3 case reports

(Source: Reactions)

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  Nationwide survey of the development of drug-resistance in the pediatric field: drug sensitivity of Haemophilus influenzae in Japan

Abstract  We evaluated the β-lactamase-producing ability and resistance to 20 antibacterial agents of 448 clinically isolated strains of Haemophilus influenzae accumulated from October 2000 to July 2001 (phase 1) and of 376 different strains accumulated from January to June 2004 (phase 2), from institutions that participated in a nationwide Drug-Resistant Pathogen Surveillance Group in Pediatric Infectious Disease. Between phase 1 and phase 2 the proportion of β-lactamase-negative ampicillin (ABPC)-susceptible (BLNAS) strains declined from 62.9% to 34.3%; the proportions of β-lactamase-positive ABPC-resistant (BLPAR) strains were 8.3% and 6.4% in phases 1 and 2, but the proportion of β-lactamase-negative ABPC-resistant (BLNAR) strains increased from 28.8% in phase 1 to ...

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  Nationwide survey of the development of drug-resistant pathogens in the pediatric field: drug sensitivity of Streptococcus pneumoniae in Japan

Abstract  We evaluated the resistance to 20 different antibacterial agents of 362 clinically isolated strains of Streptococcus pneumoniae accumulated from October 2000 to July 2001 (phase 1) and of 332 different strains accumulated from January to June 2004 (phase 2), from institutions throughout Japan that participated in the surveys carried out by the Drug-Resistant Pathogen Surveillance Group in Pediatric Infectious Disease. In phase 1, the proportions of penicillin-sensitive S. pneumoniae (PSSP), penicillin-insensitive S. pneumoniae (PISP), and penicillin-resistant S. pneumoniae (PRSP) were 35.4%, 34.8%, and 29.8%, respectively, and the proportions were almost the same in phase 2: 33.1%, 37.0%, and 29.8%, respectively. Comparison of the MIC90 values of the antibacterial ag...

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  [Case Report] Fulminant colitis and toxic myocarditis: a unifying cause?

In June, 2006, a 44-year-old previously healthy woman from a poor socio-economic background presented to us with a 5-day history of fever, dyspnoea, tight chest pain, and postural dizziness. This was preceded by an episode of diarrhoea over a week. On admission, respiratory rate was 40 breaths per min, radial pulse was regular at 130 beats per min, and blood pressure was 80/50 mm Hg. She had central cyanosis, was sweating profusely, and had cold peripheries. Heart sounds showed triple rhythm and she had fine basal crepitations in her lungs. Her abdomen was soft and non-tender; there was no sign of hepatosplenomagaly or ascites. She was promptly resuscitated with intravenous fluids, but required intubation and mechanical ventilation in the intensive care unit. Broad-spectrum antibiotics in...

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  Successful treatment of severe conjunctivitis and blepharitis caused by Escherichia coli in an ostrich (Struthio camelus)

Abstract  The aim of the present report was to describe the clinical features and antibiotic susceptibility of severe conjunctivitis and blepharitis caused by Escherichia coli in an ostrich. A 2-month-old ostrich chick was presented with a 5-day history of left periocular swellings and severe conjunctivitis and blepharitis. There were no other abnormalities. The bacteria cultured from the pus aspirated from the periocular swellings were identified to be E. coli. Sensitivities were determined by a modified disc diffusion method, and isolates were fully susceptible to ciprofloxacin, co-trimoxazole, gentamicin, amikacin and chloramphenicol. The ostrich was treated by intramuscular ceftriaxone (10 mg/kg) BID for 1 week. The eye was treated with topical 0.3% ciprofloxac...

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  Ineffectiveness of Tigecycline Against Persistent Borrelia burgdorferi.

Authors: Barthold SW, Hodzic E, Imai DM, Feng S, Yang X, Luft BJ The effectiveness of a new first in class antibiotic, tigecycline (glycylcycline), was evaluated during the early dissemination (1 week), early immune (3 weeks), or late persistent (4 months) phases of Borrelia burgdorferi infection in C3H mice. Mice were treated with high or low doses of tigecycline, saline (negative-effect controls), or a previously published regimen of ceftriaxone (positive-effect controls). Infection status was assessed at 3 months after treatment by culture, quantitative ospA real-time PCR, and subcutaneous transplantation of joint and heart tissue into SCID mice. Tissues from all saline-treated mice were culture- and ospA PCR-positive; tissues from all antibiotic-treated mice were culture-negative; ...

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  A comparison of culture-positive and culture-negative healthcare-associated pneumonia.

CONCLUSION: In this analysis, CN HCAP patients had lower severity of illness, hospital mortality, and hospital length of stay compared to CP patients. These data suggest that CN HCAP patients differ substantially from HCAP patients with positive microbiologic cultures. PMID: 19965954 [PubMed - as supplied by publisher] (Source: Chest)

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  Salmonella myocarditis in a young adult patient presenting with acute pulmonary edema, rhabdomyolysis, and multi-organ failure.

We present a rare case of salmonella myocarditis with multi-organ failure in a previously healthy young adult man who was brought to the emergency room with fever, diarrhea, shortness of breath, and altered sensorium, discovered to have acute pulmonary edema and respiratory compromise for which he was assisted with mechanical ventilation for 8 days. Blood culture grew Salmonella typhi. Biochemically he exhibited myocardial, hepatic, and muscular enzymatic surge with renal failure, features of rhabdomyolysis, and disseminated intravascular coagulation. The patient showed a progressive improvement on treatment with ceftriaxone for 2 weeks in addition to decongestive therapy. He was discharged in good condition afterward. PMID: 19944325 [PubMed - in process] (Source: Journal of Cardiology...

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  Evaluation of ceftriaxone utilization at multicenter study.

CONCLUSIONS: Appropriate use (65.5%) of ceftriaxone was higher than inappropriate use (34.5%) at university hospitals in Korea. Inappropriate utilization, however, including continued empiric use for presumed infections and prophylactic perioperative injection remained high. Intensification of educational programs and antibiotic control systems for ceftriaxone is needed to improve the suitability of antimicrobial use. PMID: 19949738 [PubMed - in process] (Source: The Korean Journal of Internal Medicine)

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  Prevalence of intestinal parasitic and bacterial pathogens in diarrhoeal and non-diarroeal human stools from Vhembe district, South Africa.

Authors: Samie A, Guerrant RL, Barrett L, Bessong PO, Igumbor EO, Obi CL In the present study, a cross-sectional survey of intestinal parasitic and bacterial infections in relation to diarrhoea in Vhembe district and the antimicrobial susceptibility profiles of isolated bacterial pathogens was conducted. Stool samples were collected from 528 patients attending major public hospitals and 295 children attending two public primary schools and were analyzed by standard microbiological and parasitological techniques. Entamoeba histolytica/E. dispar (34.2%) and Cryptosporidium spp. (25.5%) were the most common parasitic causes of diarrhoea among the hospital attendees while Giardia lamblia (12.8%) was the most common cause of diarrhoea among the primary school children (p < 0.05). Schisto...

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  The influence of antibiotics on the changing epidemiology of Clostridium difficile.

Authors: Taori SK, Hall V, Poxton I An increase in incidence of clinical cases of Clostridium difficile infection has been reported in recent years but few studies have examined the changes in molecular epidemiology and antibiotic resistance over a long period of time. A collection of 179 isolates of C. difficile obtained from symptomatic adult patients in southern Scotland between 1979 and 2004 was used to determine changes in the prevalence of epidemiological types and antibiotic susceptibilities to common antibiotics. PCR ribotyping and MICs were performed on all isolates. A total of 56 different ribotypes was identified among which ribotype 002 was the commonest type overall (14%), followed by ribotypes 014 (7.3%), 012 (5%), 015 (5%), 020(5%), and 001 (4.5%). Ribotype 078 was also ...

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  Effects of reducing beta-lactam antibiotic pressure on intestinal colonization of antibiotic-resistant gram-negative bacteria

Conclusion  A 35–39% reduction of β-lactam exposure was not associated with reduced acquisition of CRE, whereas a 243% increase of fluoroquinolone use increased acquisition of FCRE. Content Type Journal ArticleCategory OriginalDOI 10.1007/s00134-009-1714-yAuthors Saskia Nijssen, St. Elisabethziekenhuis Department of Medical Microbiology Hilvarenbeekse Weg 60 5022 GC Tilburg The NetherlandsAd Fluit, University Medical Center Utrecht Department of Medical Microbiology, Julius Center for Health Sciences and Primary Care Heidelberglaan 100 3584 CX Utrecht The NetherlandsDavid van de Vijver, Erasmus Medical Center Rotterdam Department of Virology Rotterdam The NetherlandsJanetta Top, University Medical Center Utrecht Department of Medical Microbiology, Julius Center for H...

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  Efficacy profile of daptomycin for the treatment of invasive as compared to non-invasive pulmonary infections with S. pneumoniae.

Authors: Henken S, Bohling J, Martens-Lobenhoffer J, Paton JC, Ogunniyi AD, Briles DE, Salisbury VC, Wedekind D, Bode-Böger SM, Welsh T, Bange F, Welte T, Maus UA Daptomycin is a novel lipopeptide antibiotic with excellent activity against Gram-positive bacterial pathogens, but its therapeutic value for the treatment of invasive pneumococcal disease as compared to pneumococcal pneumonia is incompletely defined. We investigated the efficacy of daptomycin in two models of S. pneumoniae-induced lung infection, i.e., pneumococcal pneumonia or septic pneumococcal disease. Mice were infected with bioluminescent, invasive serotype 2 or less virulent serotype 19 S. pneumoniae, followed by semi-therapeutic or therapeutic daptomycin or ceftriaxone treatment. Readouts included survival, bact...

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  False-positive widal in melioidosis

Valsalan Rohith, Shubha S, Mukhopadhyay C, Saravu K, Maneesh M, Shastry B A, Rau N R, Pandit V R, Gonsalves HazelIndian Journal of Medical Sciences 2009 63(10):464-467Enteric fever is endemic in this part of the world, and Widal test is one of the time-honored laboratory tests that are being used for years to diagnose the disease. On the other hand, melioidosis is a newly emerging disease from this region, which is most often misdiagnosed or underdiagnosed by clinicians. It is well accepted that false-positive Widal reactions following certain non-typhoid Salmonella infections may occur commonly. Three cases of high titers of Widal test are described, where melioidosis was the actual diagnosis in every occasion and was never suspected until diagnosed microbiologically. All the patients had...

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  What Evaluation is Appropriate for Complex Febrile Seizures?

Discussion Febrile seizures are the most common type of seizures in children. They affect about 2-5% of all children. Febrile seizures are characterized into two groups: simple febrile seizures and complex febrile seizures. Basically, if the child does not meet the criteria for a simple febrile seizure it is called a complex febrile seizure. The main characteristics are outlined below: Simple Febrile Seizure Complex Febrile Seizure Age 6-60 months < 6 months or > 60 months Duration < 15 minutes > 15 minutes Type Generalized Focal seizures tonic-clonic Tonic and/or clonic Partial seizure with/without generalization Head or eye deviation to one side Unilateral transient paralysis after seizure Loss of musc...

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  Incompatibility of Ceftriaxone Sodium with Calcium-containing Products.

Authors: Nakai Y, Tokuyama E, Yoshida M, Uchida T The purpose of this study was to evaluate the incompatibility of ceftriaxone with calcium-containing products, which had been the subject of an ALERT issued by the FDA. The influence of calcium ion concentration, storage temperature and shaking on the appearance and quantity of insoluble microparticles in mixtures of the two was examined using a light obscuration particle counter and a stereomicroscope. Appropriate volumes of 2% (w/v) calcium chloride solution were added to ceftriaxone sodium for injection (10 mg/ml) to make solutions with final calcium ion concentrations of 0.5-2.5 mmol/l, and stored at 20 degrees C, 25 degrees C, or 30 degrees C. The number of insoluble microparticles increased on storage when the calcium ion concentr...

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  Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae in HIV-Seropositive Patients and Gonococcal Antimicrobial Susceptibility: an Update in Thailand.

Authors: Srifeungfung S, Roongpisuthipong A, Asavapiriyanont S, Lolekha R, Tribuddharat C, Lokpichart S, Sungthong P, Tongtep P We surveyed the rate of chlamydial and gonococcal infections among human immunodeficiency virus (HIV)-seropositive patients in Thailand as well as the current status of antimicrobial resistance of Neisseria gonorrhoeae and determined the prevalence of penicillinase-producing N. gonorrhoeae (PPNG) in Thailand. A total of 1,158 endocervical swabs from 824 HIV-seropositive patients were collected to detect both organisms by Gen-Probe. The prevalences of chlamydial and gonococcal infection were 9.7 and 1.3%, respectively. Susceptibility of 122 gonococcal isolates to 6 drugs was determined by the disk diffusion method. None of the isolates was susceptible to penici...

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  Interleukin-10/Ceftriaxone prevents E.Coli-induced delays in sensorimotor task learning and spatial memory in neonatal and adult Sprague Dawley rats.

Authors: Wallace KL, Lopez J, Shaffery JP, Paul IA, Bennett WA Intrauterine infection during pregnancy is associated with early activation of the fetal immune system and poor neurodevelopmental outcomes. Immune activation can lead to alterations in sensorimotor skills, changes in learning and memory and neural plasticity. Both interleukin-10 (IL-10) and Ceftriaxone have been shown to decrease immune system activation and increase memory capacity, respectively. Using a rodent model of intrauterine infection, we examined sensorimotor development in pups, learning and memory, via the Morris water maze, and long-term potentiation in adult rats. Pregnant rats at gestational day 17 were inoculated with 1 X 10(5) colony forming units of Escherichia coli (E.Coli) or saline. Animals in the trea...

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  Efficacy of Ceftriaxone or Meropenem as Initial Therapies in Whipple's Disease

Conclusions: This was a randomized controlled trial to show that treatment with ceftriaxone or meropenem, followed by trimethoprim–sulfamethoxazole, cures patients with Whipple's disease. One asymptomatic individual with infection of the cerebrospinal fluid required additional therapy. (Source: Gastroenterology)

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  Recurrent systemic infections with Streptococcus pneumoniae do not aggravate the course of experimental neurodegenerative diseases

In conclusion, onset and course of disease in mouse models of three common neurodegenerative disorders were not influenced by repeated systemic infections with S. pneumoniae, indicating that the effect of moderately severe acute infections on the course of neurodegenerative diseases may be less pronounced than suspected. © 2009 Wiley-Liss, Inc. (Source: Journal of Neuroscience Research)

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  Health Canada updates ceftriaxone prescribing information

(Source: Reactions)

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  Rocephin 250mg, 1g, 2g vials (ceftriaxone) - Revised SPC

Source: eMC (electronic Medicines Compendium) Area: Other Library Updates > SPC Changes Revised SPC includes updates to: Section 4.2 (method of administration) - Diluents containing calcium, (e.g. Ringer's solution or Hartmann's solution), should not be used to reconstitute ceftriaxone vials or to further dilute a reconstituted vial for IV administration because a precipitate can form. Precipitation of ceftriaxone-calcium can also occur when ceftriaxone is mixed with calcium-containing solutions in the same IV administration line. Therefore, ceftriaxone and calcium-containing solutions must not be mixed or administered simultaneously Section 4.3 (contraindications) - Premature newborns up to a corrected age of 41 weeks (weeks of gestation + weeks of life); Full-term newborns (up to ...

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  Prevalence of serotypes and antimicrobial resistance of invasive strains of pneumococcus in children: analysis of 9 years.

CONCLUSIONS: Penicillin resistance was detected in 9.9% of the strains, being predominant from 2004 to 2008. Twenty different pneumococcal serotypes were identified, and 71.9% of the serotypes were represented in the 7-valent conjugate vaccine (PN CRM7) currently available. PMID: 19859623 [PubMed - as supplied by publisher] (Source: Jornal de Pediatria)

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  Community-acquired Acinetobacter baumannii meningitis in a previously healthy 14-month-old boy

We report a previously healthy 14-month-old boy who developed community-acquired Acinetobacter baumannii meningitis. He had no history of immunodeficiency, and was brought to Konan Kosei Hospital with a high fever and vomiting. His consciousness was clear, but neck stiffness was noted. Examination of the cerebrospinal fluid (CSF) revealed a cell count of 10 112/µl; protein, 216 mg/dl; and glucose, 9 mg/dl. A CSF test kit for bacterial capsular antigens (Pastorex Meningitis; Bio-Rad Laboratories) was positive for Haemophilus influenzae type b antigen. On day 3 of admission, the microorganism isolated by CSF culture was identified as A. baumannii. Therefore, his treatment was changed to meropenem hydrate from the initial therapy with panipenem/betamipron and ceftriaxone sodium hydrate. ...

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  Empiric antibiotic therapy in acute uncomplicated urinary tract infections and fluoroquinolone resistance: a prospective observational study

Background: The aims of this study were to determine the antimicrobial susceptibility patterns of urinary isolates from community acquired acute uncomplicated urinary tract infections (uUTI) and to evaluate which antibiotics were empirically prescribed in the outpatient management of uUTI. Methods: Among the patients which were admitted to outpatient clinics of Ankara University Medical Faculty, Ibni-Sina Hospital during 2005-2006, a total of 429 women between the age of 18 and 65 years old who were clinically diagnosed with uUTI and to whom prescribed empirical antibiotics were enrolled in this prospective observational study. Patients' demographical data, urine culture results, resistance rates to antimicrobial agents and prescribed empiric antimicrobial therapy were analyzed. Results: T...

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  Beta-Lactam Resistance in Salmonella Isolated from Retail Meats in the United States: National Antimicrobial Resistance Monitoring System (NARMS): 2002-2006.

Authors: Zhao S, Blickenstaff K, Glenn A, Ayers SL, Friedman SL, Abbott JW, McDermott PF Ampicillin-resistant (AMP(R)) Salmonella (n=344) representing 32 serotypes isolated from retail meats from 2002-2006 were tested for susceptibility to 21 other antimicrobial agents, and screened for the presence of five beta-lactamase gene families (blaCMY, blaTEM, blaSHV, blaOXA, blaCTX-M) and class 1 integrons. Among the AMP(R) isolates, 66.9% were resistant to >/=5 antimicrobials and 4.9% to >/= 10 antimicrobials. Co-resistance to other beta-lactams was noted for amoxicillin/clavulanic acid (55.5%), ceftiofur (50%), cefoxitin (50%), and ceftazidime (24.7%), whereas less than 5% of isolates were resistant to piperacillin/tazobactam (4.9%), cefotaxime (3.5%), ceftriaxone (2%), and aztreonam ...

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  MHRA highlights interaction between ceftriaxone and calcium

(Source: Reactions)

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  Med Sci Monit 2009; 15(11):CR579-582 "Susceptibility pattern of E. coli-associated urinary tract infection (UTI): A comparison of spinal cord injury-related and nosocomial UTI"

Conclusions: Despite more risk factors for antibiotic-resistant E. coli in SCI patients, antibiotic-resistant E. coli was observed more in nosocomial UTIs, which may be attributable to the hospital environment. (Source: Medical Science Monitor)

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  Polyserositis due to Salmonellaenterica serovar Enteritidis

Summary: Salmonella enterica serovar Enteritidis (S. Enteritidis), a non-typhoid Salmonella, is an important emerging pathogen that usually causes gastroenteritis. Here, we report polyserositis with right-sided pleural effusion and loculated collection of fluid in the peritoneum caused by S. Enteritidis in a 60-year-old man from southern India. The patient was immunocompetent and did not have preceding gastroenteritis or any local structural abnormality. Malnutrition and old age might have been the predisposing factors. The patient received intravenous ceftriaxone for 2 weeks followed by oral ciprofloxacin. Pleurocentesis and abdominal paracentesis were also done. The patient was cured as evidenced by clinical improvement and radiological disappearance of the fluid collection. (Source: Tra...

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  A Meta-Analysis of Randomized Controlled Trials Assessing the Prophylactic Use of Ceftriaxone. A Study of Wound, Chest and Urinary Infections

Content Type Journal ArticleCategory Invited CommentaryDOI 10.1007/s00268-009-0232-yAuthors Markus Schäfer, University Hospital Department of Visceral and Transplantation Surgery Rämistrasse 100 8091 Zürich SwitzerlandPierre-Alain Clavien, University Hospital Department of Visceral and Transplantation Surgery Rämistrasse 100 8091 Zürich Switzerland Journal World Journal of SurgeryOnline ISSN 1432-2323Print ISSN 0364-2313 (Source: World Journal of Surgery)

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  FDA releases quarterly list of early investigations into potential adverse drug reactions identified between January and March 2009

Source: FDA, Reuters Health News Area: News The FDA has published its quarterly list of safety probes, which forms part of the effort to inform the public about early investigations into potential adverse drug reactions that have been reported. The current list covers issues identified between January and March 2009 as follows:   1. Ceftriaxone (Rocephin®): Hemolytic anaemia 2. Diclofenac epolamine patch (Flector®): Hypersensitivity reactions 3. Didanosine (Videx®): Portal hypertension 4. Entacapone (Comtan): Colitis 5. Gadolinium-based contrast agents: Anaphylaxis 6. Alpha interferon products: Pulmonary Hypertension 7. Mecasermin products (Increlex®, Iplex®): Hypersensitivity reactions 8. Methylnaltrexone (Relistor®): Gas...

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  MHRA Drug Safety Update October 2009: Incompatibility of ceftriaxone (Rocephin®) with calcium containing solutions

Source: MHRA Area: Evidence > Medication Safety In November 2007, the MHRA advised healthcare professionals that ceftriaxone should not be mixed or simultaneously infused with calcium-containing solutions such as Hartmann's or Ringer's because of a risk of precipitation. It also advised that ceftriaxone is contraindicated in newborns who need calcium treatment because of a risk of precipitation of ceftriaxone calcium salt. Following a review of data, the October issue of the MHRA's Drug Safety Update provides a reminder and further advice for healthcare professionals as follows:   . Ceftriaxone is contraindicated in premature newborns up to a corrected age of 41 weeks (weeks of gestation+weeks of life), full-term newborns up to age 28 days who need treatment with calcium-con...

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  Health-care associated infections rates, length of stay, and bacterial resistance in an intensive care unit of Morocco: Findings of the International Nosocomial Infection Control Consortium (INICC)

Conclusion: HAI rates, LOS, mortality, and bacterial resistance were high. Even if data may not reflect accurately the clinical setting of the country, programs including surveillance, infection control, and antibiotic policy are a priority in Morocco. (Source: International Archives of Medicine)

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  Ceftriaxone: Agranulocytosis: case report

(Source: Reactions)

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  Emergence of multidrug-resistant Salmonella enterica serovar Typhi with reduced susceptibility to fluoroquinolones in Cambodia

Abstract: From December 2006 to April 2009, we conducted an etiology study among Cambodian patients presenting with acute fever of unknown origin. Salmonella enterica serovar Typhi was detected in 0.9% (41/4985) blood cultures. Antimicrobial susceptibility testing showed decreased susceptibility to ampicillin (56% resistant; MIC90, >256 μg/mL), chloramphenicol (56% resistant; MIC90, >256 μg/mL), trimethoprim/sulfamethoxazole (56% resistant; MIC90, >256 μg/mL), nalidixic acid (81% resistant; MIC90, not defined), ciprofloxacin (0% resistant; MIC90, 0.5 μg/mL), and ceftriaxone (0% resistant; MIC90, 0.094 μg/mL). Multidrug resistance, defined as antimicrobial resistance to ampicillin, chloramphenicol, and trimethoprim/sulfamethoxazole, was found in 56% of the isolates, and 80% had reduced...

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  CTX-M and ampC β-lactamases contributing to increased prevalence of ceftriaxone-resistant Escherichia coli in Changi General Hospital, Singapore

Abstract: Data from an 800-bed hospital showed an increase in the incidence density of ceftriaxone-resistant Escherichia coli, from 13.1 to 21.7 per 100 000 inpatient days over a 4-year period. Detailed testing performed on 54 E. coli isolates showed blaCTX-M extended-spectrum β-lactamase (ESBL) genes (n = 37) and blaCMY-like ampC genes (n = 15). Typing data showed only limited clonal transmission in isolates with ESBL. (Source: Diagnostic Microbiology and Infectious Disease)

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  Activity of ertapenem, ciprofloxacin, ceftriaxone, piperacillin-tazobactam, and ampicillin-sulbactam against 12 common clinical isolates of community-acquired bacteremia.

CONCLUSIONS: ESBL E. coli and K. pneumoniae are highly resistant to ciprofloxacin, so this antibiotic should be avoided for patients with community-acquired bacteremia. ESBL E. coli and K. pneumoniae are highly susceptible to ertapenem. PMID: 20182674 [PubMed - in process] (Source: Journal of Microbiology, Immunology, and Infection)

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  Invasive pediatric Neisseria meningitidis infections.

CONCLUSIONS: Serogroup B and W-135 were 2 predominant serogroups to cause pediatric meningococcus, and the majority of infections occurred in children younger than 1 year. Continuous surveillance and prevention of meningococcal infections are of great importance. PMID: 20182673 [PubMed - in process] (Source: Journal of Microbiology, Immunology, and Infection)

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  Simultaneous multiresponse optimization of an HPLC method to separate seven cephalosporins in plasma and amniotic fluid: application to validation and quantification of cefepime, cefixime and cefoperazone.

Authors: Nemutlu E, Kir S, Katlan D, Beksaç MS An HPLC method for the separation of seven cephalosporins [Cefepime (CEP), ceftazidime (CTA), ceftizaxime (CTI), ceftriaxone (CTR), cefotaxime (COT), cefixime (CIX) and cefoperazone (COP)] in human plasma and amniotic fluid has been developed. Optimization of the chromatographic method was performed in three steps: a series of initial experiments followed by two sets of experiments based on different experimental designs. The initial experiments were performed to decide the basic analytical requirements of the method. Then screening experiment fractional factorial design was used in order to decrease the number of parameters by eliminating parameters which having insignificant effect on responses. The parameters having significant eff...

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  Changing trends in antimicrobial resistance of Salmonella enterica serovar typhi and salmonella enterica serovar paratyphi A in Chennai.

CONCLUSION: The study indicates reemergence of chloramphenicol-susceptible Salmonella enterica serovar typhi and paratyphi A isolates, a significant decline in MDR strains and high resistance to nalidixic acid. E1 phage type and biotype 1 are found to be most prevalent in Chennai, India. PMID: 19805957 [PubMed - in process] (Source: Indian Journal of Pathology and Microbiology)

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  Infective endocarditis caused by Salmonella enteritidis in a dialysis patient: a case report and literature review

Conclusion: Although there are several reports that Salmonella endocarditis without cardiac failure can be successfully treated with antibiotics alone, early surgical intervention is essential for some cases to prevent life-threatening complications. Transesophageal echocardiography should be performed in any patient with high clinical suspicion of infective endocarditis for the early detection and the early surgical intervention. To the best of our knowledge, this is the first case-report of Salmonella endocarditis in a haemodialysis patient. (Source: BMC Infectious Diseases)

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  Two Phase 3 Trials Show Benefits of Ceftaroline for Community-Acquired Pneumonia

Two phase 3 trials show ceftaroline is equivalent to ceftriaxone in treating community-acquired pneumonia, but some have expressed doubts about the potency and applicability of the new antibiotic. Medscape Medical News (Source: Medscape Today Headlines)

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  Bacteremia in febrile nonneutropenic pediatric oncology patients

We sought to determine the risk of bacteremia in a cohort of outpatient febrile nonneutropenic pediatric oncology patients and to assess clinical characteristics that may influence decisions regarding empiric antibiotic therapy.A single institution retrospective cohort study was performed of outpatient pediatric oncology patients presenting with fever, a central venous catheter, and an absolute neutrophil count (ANC) of [ge]500/µl over a 6-year period. We also collected data regarding the presence of clinically evident infections, antibiotics prescribed, and the sensitivity of bacteria to specific antibiotics.There were 29 cases of bacteremia in 459 (6.3%) febrile outpatient visits by 167 patients. Bacteremia was documented in 4.4% of patients with ports and in 16.2% of patients with exte...

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  Multidrug-resistant Neisseria gonorrhoeae with reduced cefotaxime susceptibility is increasingly common in men who have sex with men, Amsterdam, the Netherlands.

Authors: de Vries HJ, van der Helm JJ, Schim van der Loeff MF, van Dam AP Antimicrobial resistance is an increasing problem in Neisseria gonorrhoeae (NG) treatment. Presently, third-generation parenteral cephalosporins, like ceftriaxone and cefotaxime, are the first option. Resistance to oral, but not to parenteral, third-generation cephalosporins has been reported previously. We analysed the microbial susceptibility (as minimum inhibitory concentration - MIC) of NG cultures obtained from high-risk visitors of the largest Dutch outpatient clinic for sexually transmitted infections (STI) in Amsterdam, the Netherlands. Among 1,596 visitors, we identified 102 patients with at least one NG isolate with reduced susceptibility to cefotaxime (0.125 microg/ml < MIC < or = 0.5 microg/ml)....

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  Neurobrucellosis: an evaluation of a rare presentation of brucellosis from a tertiary care centre in Central Anatolia, Turkey.

We describe our experience of the diagnosis, treatment and final outcome of patients with neurobrucellosis at the Erciyes University Gevher Nesibe Hospital, a tertiary referral centre in Central Anatolia, Turkey. Thirty-six adult patients were diagnosed with neurobrucellosis from January 1997 to December 2006. Headache and fever were the most common symptoms. Neck stiffness was present in 25 patients. Brucella spp was isolated from the blood of nine patients and from the cerebrospinal fluid of 11. Doxycycline (by mouth) plus rifampin (by mouth) with ceftriaxone (intravenously) were the most common treatment choices. Three patients died as a result of problems other than neurobrucellosis and relapse occurred in one patient. Neurobrucellosis presents with hetoregenous clinical signs. PMI...

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  Multidrug-resistant Neisseria gonorrhoeae with reduced cefotaxime susceptibility is increasingly common in men who have sex with men, Amsterdam, the Netherlands

Antimicrobial resistance is an increasing problem in Neisseria gonorrhoeae (NG) treatment. Presently, third-generation parenteral cephalosporins, like ceftriaxone and cefotaxime, are the first option. Resistance to oral, but not to parenteral, third-generation cephalosporins has been reported previously. We analysed the microbial susceptibility (as minimum inhibitory concentration - MIC) of NG cultures obtained from high-risk visitors of the largest Dutch outpatient clinic for sexually transmitted infections (STI) in Amsterdam, the Netherlands. Among 1,596 visitors, we identified 102 patients with at least one NG isolate with reduced susceptibility to cefotaxime (0.125 ?g/ml < MIC ? 0.5 ?g/ml). The percentage of NG isolates with reduced susceptibility to cefotaxime rose from 4.8% in 2006 t...

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  What Are Some Common Presentations for Inborn Errors of Metabolism?

Discussion Each inborn errors of metabolism (IEM) by itself is often rare but taken as a whole, IEM are common. IEM often present in the newborn or infancy periods but can present at any time including adulthood. The genetic defect often causes a problem in the catabolism or synthesis of carbohydrates, fats, or proteins. The defect causes a blockage in the metabolic pathway with intermediate molecules accumulating (often toxic accumulations) before the blockage and metabolites after the blockage being scarce (inadequate energy production/utilization). Diet and stresses including surgery, trauma, and illness often can trigger intermittent decompensation. Common IEM include: Carbohydrate metabolism - carbohydrate intolerance, geoneogenic and glycogenolytic disorders, glycogenic storage def...

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  Cost-Effectiveness of Ceftriaxone and Amikacin as Single Daily Dose for the Empirical Management of Febrile Granulocytopenic Children with Cancer

Chemotherapy 1997;43:358-366 (DOI:10.1159/000239590) (Source: Chemotherapy)

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  Neisseria gonorrhoeae antibiotic resistance in Paris, 2005 to 2007: implications for treatment guidelines.

The objective of this study was to appraise: (i) the antimicrobial susceptibility of Neisseria gonorrhoeae in a venereology clinic in Paris, between 2005 and 2007; and (ii) the factors associated with quinolone-resistant N. gonorrhoeae. A prospective study of consecutive cases was performed for the period 2005 to 2007. Susceptibility of N. gonorrhoeae to five antibiotics (ciprofloxacin, ceftriaxone, spectinomycin, penicillin G and tetracycline) was tested systematically. Clinical and epidemiological data were collected using a standardized form. Male-to-female sex ratio was 22.0. Median age was 30.0 years. Of 115 cases, 84 occurred in men having sex with men (72.6%) and 22 involved the anorectal area (19.1%). The rate of quinolone-resistant N. gonorrhoeae was 37.4% (43/115), without signif...

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  Induction of Nrf2 and xCT are involved in the action of the neuroprotective antibiotic ceftriaxone in vitro

In amyotrophic lateral sclerosis, down-regulation of the astrocyte-specific glutamate excitatory amino acid transporter 2 is hypothesized to increase extracellular glutamate, thereby leading to excitotoxic motor neuron death. The antibiotic ceftriaxone was recently reported to induce excitatory amino acid transporter 2 and to prolong the survival of mutant superoxide dismutase 1 transgenic mice. Here we show that ceftriaxone also protects fibroblasts and the hippocampal cell line HT22, which are not sensitive to excitotoxicity, against oxidative glutamate toxicity, where extracellular glutamate blocks cystine import via the glutamate/cystine-antiporter system xc[minus]. Lack of intracellular cystine leads to glutathione depletion and cell death because of oxidative stress. Ceftriaxone incr...

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  Environmental risk assessment of antibiotics: An intensive care unit analysis.

Authors: de Souza SM, de Vasconcelos EC, Dziedzic M, de Oliveira CM Hospital effluents have been usually known by the microbiological pollution they cause, but only recently they have been considered a significant source of aquatic environmental pollution due to the presence of medicines in these effluents. In this context, an environmental risk assessment (ERA) is presented for the most used intravenous antibiotics in the Intensive Care Unit (ICU) of a hospital in Curitiba (Brazil). The amount of antibiotics used in the ICU was evaluated during 18months (June 2006 until November 2007), in order to calculate the Predicted Environmental Concentration (PEC1). Antibiotic excretion data (on its original form) and the removal of the selected drugs in the sewage treatment plants based on the...

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  Ceftriaxone: Toxic hepatitis in a child: case report

(Source: Reactions)

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  Characterization and anti - microbial susceptibility of gram - negative bacteria isolated from bloodstream infections of cancer patients on chemotherapy in Pakistan

Conclusion:&lt;/b&gt; High resistance observed in this study warrants the needs of surveillance of resistant pattern of antimicrobial agents. Due to increased level of drug resistance, carbapenem would be a prudent choice in high- risk cases. (Source: Indian Journal of Medical Microbiology)

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  Magnitude of drug resistant shigellosis: A report from Bangalore

Srinivasa H, Baijayanti M, Raksha YIndian Journal of Medical Microbiology 2009 27(4):358-360&lt;i&gt;Shigella&lt;/i&gt; is an important cause of acute invasive diarrhea in children and others. Antimicrobial susceptibility of &lt;i&gt; Shigella&lt;/i&gt; spp. isolated from diarrhoeal/ dysenteric patients in Bangalore was studied in our hospital from January 2002 to December 2007. One hundred and thirty-four isolates were identified as &lt;i&gt; Shigella&lt;/i&gt; species. &lt;i&gt; S. flexneri, S. sonnei&lt;/i&gt; , &lt;i&gt; S. boydii &lt;/i&gt; and &lt;i&gt; S. dysenteriae&lt;/i&gt; were accounted respectively for 64.9�...

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  Efficacy of Short Course,

Conclusion: There is no evidence of an increased risk of treatment failure with short course of antibiotics for acute otitis media. Among the short-course regimens, azithromycin use was associated with a lower risk of treatment failure while short-acting oral antibiotics and parenteral ceftriaxone may be associated with a higher risk of treatment failure. PMID: 19736367 [PubMed - as supplied by publisher] (Source: Indian Pediatrics)

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  Ceftriaxone Restores Glutamate Homeostasis and Prevents Relapse to Cocaine Seeking

Conclusions: These results indicate that glutamate transport and cystine-glutamate exchange may be coregulated and provide further evidence that targeting glutamate homeostasis is a potential method for treating cocaine relapse. (Source: Biological Psychiatry)

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  Renal amyloidosis in Whipple disease: a case report

Conclusions: To our knowledge based on systematic review, this is the first case report on Whipple disease complicated by secondary amyloidosis and kidney failure maintained on permanent renal replacement therapy. It is strongly suspected that the use of immunosuppressive treatment in such cases may exacerbate the course of Whipple disease and cause life-threatening complications. (Source: Cases Journal)

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  Endogenous Aspergillus Endophthalmitis Occurring After Liver Transplantation: A Case Report

In this report, we have described a patient who underwent liver transplantation because of drug-induced cholestatic cirrhosis and developed AE at 2 weeks after the surgery. The patient was a 22-year-old man who received a right liver lobe from his father. The operation was uneventful but the patient developed signs and symptoms of small-for-size syndrome after the second day of surgery. The patient received intense immunosuppression with methylprednisolone for 3 days, tacrolimus and mycophenolate mofetil from the first day after the operation, with ceftriaxone and metronidazole as prophylactic antibiotics. Because of signs of respiratory distress with pneumonia, vancomycin and amphotericin B were added empirically to his regimen. Polymerase chain reaction for aspergillus DNA in the blood w...

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  Emergence of Extended-Spectrum Beta-Lactamases in Clinical Isolates of Salmonella enterica in Tehran, Iran.

Authors: Hamidian M, Tajbakhsh M, Walther-Rasmussen J, Zali MR The purpose of the current study was to investigate the presence and molecular type(s) of extended-spectrum beta-lactamases (ESBLs) in Salmonella spp. isolates obtained from patients with diarrhea in hospitals of Tehran, Iran. Over a period of 17 months, 129 Salmonella spp. were isolated from fecal samples and tested for susceptibility using the Kirby-Bauer disk diffusion method; then, screening for ESBL-producing isolates and determination of their minimum inhibitory concentrations were carried out using the combined disk method and standard agar dilution method, respectively. The presence and type of ESBL-encoding genes were determined by PCR and sequence analysis. The isolates were all identified as Salmonella enterica o...

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  New susceptibility breakpoints in antimicrobial resistance rates of invasive pneumococcal strains.

CONCLUSIONS: When the new breakpoints for in vitro susceptibility were applied, penicillin resistance rates dropped 97%, from 33 to 1%. PMID: 19830357 [PubMed - in process] (Source: Jornal de Pediatria)

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  Drug interaction software and the risk of using ceftriaxone with therapeutic hemapheresis.

Authors: Motroni M, Reilly C PMID: 19710432 [PubMed - in process] (Source: American Journal of Health-System Pharmacy : AJHP)

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  Brain abscess due to viridans streptococci in a severely immunosuppressed HIV-infected patient

We report a case of viridans streptococcus brain abscess in a severely immunosuppressed HIV-infected patient with a history of chronic sinusitis. A 39-year-old homosexual man showed mental confusion and worsening of a frontal brain lesion after two weeks with antitoxoplasma therapy. Empiric treatment for central nervous system tuberculosis and pyogenic brain abscess was started. He underwent surgical drainage and the diagnosis of brain abscess due to viridans streptococci was confirmed. All empiric treatments were stopped and ceftriaxone was used for eight weeks, showing complete clinical and radiological resolution. Although infrequent, viridans streptococci, a common pyogenic aetiology of brain abscess in immunocompetent patients, should be considered in the differential diagnosis of bra...

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  Lyme disease serology in amyotrophic lateral sclerosis

Lyme disease is sometimes part of the differential diagnosis for amyotrophic lateral sclerosis (ALS). Herein we report on 414 individuals with ALS at the Massachusetts General Hospital who underwent laboratory testing for Lyme disease. Twenty-four (5.8%) were seropositive, but only 4 (0.97%) had confirmed past immunoreactive infection. Two of these patients received ceftriaxone for 1 month without clinical improvement. Lyme disease was rare in 414 patients with ALS and is not likely to be causative. Muscle Nerve, 2009 (Source: Muscle and Nerve)

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  Moxifloxacin is non-inferior to combination therapy with ceftriaxone plus metronidazole in patients with community-origin complicated intra-abdominal infections

Abstract: Management of community-origin complicated intra-abdominal infections (cIAIs) requires surgical intervention and antimicrobial therapy. This multinational, randomised, double-blind clinical trial carried out in Asia compared the efficacy and safety of moxifloxacin monotherapy and ceftriaxone/metronidazole combination therapy in adults with confirmed or suspected cIAI. Patients received surgical intervention and either intravenous (i.v.) moxifloxacin 400mg once daily or i.v. ceftriaxone 2g once daily plus i.v. metronidazole 500mg twice daily. A total of 364 patients were randomised [intent-to-treat (ITT), moxifloxacin N=180, comparator N=181; per-protocol (PP), moxifloxacin N=174, comparator N=171]. The most common cIAI diagnosis was complicated appendicitis. Moxifloxacin was non-...

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  Ceftriaxone: Anaphylaxis managed by desensitisation: case report

(Source: Reactions)

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  Prophylactic effect of clarithromycin in skin flap complications in cochlear implants surgery

To assess the usefulness of postoperative clarithromycin versus classical postoperative prophylaxis with occlusive dressing to prevent cochlear implant skin flap complications.Cohort study.Surgical site infections were compared in four groups: 1) ceramic/classical postoperative cares (21 patients), 2) titanium-silicon/classical postoperative cares (75), 3) ceramic/clarithromycin (24), and 4) titanium-silicon/clarithromycin (76). Preoperative ceftriaxone was systematically used in all patients in all four groups. Patients were followed up for at least 4 months. Attributable risk and number needed to treat were calculated.All infections appeared in titanium-silicon covered implants, and the risk of surgical site infection was 8.1 times higher in patients treated only with ceftriaxone and cla...

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  Streptococcus pneumoniae Serotype 3 among Costa Rican Children with Otitis Media: clinical, epidemiological characteristics and antimicrobial resistance patterns

Conclusion: Streptococcus pneumoniae serotype 3 is an important pathogen in Costa Rican children with otitis media, especially in children older than 24 months of age (P=0.05). Most serotype 3 isolates were susceptible to penicillin, cephalosporins, macrolides and quinolones. (Source: BMC Pediatrics - Latest articles)

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  Ampicillin plus Ceftriaxone Combination for E. faecalis Orthopedic Infections. A Pilot Study.

Authors: Euba G, Lora-Tamayo J, Murillo O, Pedrero S, Cabo J, Verdaguer R, Ariza J Serious E. faecalis infections usually require combination therapy to achieve bactericidal effect. In orthopedic infections, the prognosis of enterococcal etiology is considered poor and the use of aminoglycosides questioned. Ampicillin-ceftriaxone combination has recently been accepted as alternative therapy for enterococcal endocarditis. After one of our patients with endocarditis and vertebral osteomyelitis was cured with ampicillin-ceftriaxone, we started a pilot study in orthopedic infections. Patients with infections due to E. faecalis (>/=2 surgical samples or blood cultures) diagnosed during 2005-2008 were recruited. Polymicrobial infections with ampicillin and ceftriaxone resistant microorgan...

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  [Activity of Ertapenem and Ceftriaxone in the eradication of Salmonella in a model of experimental peritonitis in mice.]

Authors: Lozano F, García M, García E, González B, García M, García F, García J Since the beginning of the 1990s, the prevalence of isolates of non-typhoidal Salmonella species resistant to antimicrobial agents, including those commonly used for the treatment of Salmonella infections such as fluoroquinolones, trimethoprim-sulfamethoxazole or beta-lactams, has increased substantially. Infections caused by multidrugresistant strains of non-typhoidal Salmonella are now frequently encountered. In order to consider an appropriate role of Ertapenem in Salmonella-due intraabdominal infections, in the present study we compare the efficacy of Ertapenem versus that of Ceftriaxone in a mouse peritonitis model. Bacteriological eradication from blood, liver and mesente...

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  Ceftriaxone: Acute pancreatitis: case report

(Source: Reactions)

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  Ceftriaxone/phenobarbital: Drug-induced hypersensitivity syndrome: case report

(Source: Reactions)

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  A Meta-Analysis of Randomized, Controlled Trials Assessing the Prophylactic Use of Ceftriaxone. A Study of Wound, Chest, and Urinary Infections

Conclusions  The meta-analysis confirms that prophylactic ceftriaxone is more effective than most other prophylactic antibiotics. This reduces SSI, UTI, and pneumonia in procedures where there is an increased risk of these infections. In such procedures, the data support using ceftriaxone as a first-line prophylactic antibiotic. Content Type Journal ArticleDOI 10.1007/s00268-009-0158-4Authors J. C. Woodfield, University of Otago Medical School Department of Surgery PO Box 913 Dunedin New ZealandN. Beshay, University of Otago Medical School Department of Surgery PO Box 913 Dunedin New ZealandA. M. van Rij, University of Otago Medical School Department of Surgery PO Box 913 Dunedin New Zealand Journal World Journal of SurgeryOnline ISSN 1432-2323Print ISSN 0364-23...

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  Up-regulation of GLT-1 severely impairs LTD at mossy fibres-CA3 synapses.

Authors: Omrani A, Melone M, Bellesi M, Safiulina V, Aida T, Tanaka K, Cherubini E, Conti F Glutamate transporters are responsible for clearing synaptically released glutamate from the extracellular space. By this action, they maintain low levels of ambient glutamate, thus preventing excitotoxic damage, and contribute to shape synaptic currents. We show that up-regulation of the glutamate transporter GLT-1 by ceftriaxone severely impaired mGluR-dependent long-term depression (LTD), induced at rat mossy fibers (MF)-CA3 synapses by repetitive stimulation of afferent fibers. This effect involved GLT-1, since LTD was rescued by the selective GLT-1 antagonist dihydrokainate (DHK). DHK per se produced a modest decrease in fEPSP amplitude that rapidly regained control levels after DHK wash ou...

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  Clinical, laboratory, and microbiological differences between children with simple or complicated mastoiditis

Conclusion: High-grade fever, high absolute neutrophil count, and high C-reactive protein level may serve as clinical and laboratory markers of complicated mastoiditis. Children with these findings warrant close follow-up and perhaps, earlier surgical intervention. (Source: International Journal of Pediatric Otorhinolaryngology)

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  FDA Safety Changes: Rocephin, Amaryl, Prandin

The FDA has approved safety labeling revisions for ceftriaxone sodium injection (Rocephin), glimepiride tablets (Amaryl), and repaglinide tablets (Prandin). Medscape Medical News (Source: Medscape Medical News Headlines)

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  Emergence of fluoroquinolone-resistant strains of Salmonella enterica in Surabaya, Indonesia

Abstract: Typhoid fever remains a major health problem in developing countries. Fluoroquinolones such as ciprofloxacin emerged as the 1st-choice treatment of enteric fever, including typhoid, in the 1990s. Recently, Salmonella typhi strains with resistance to ciprofloxacin have been increasingly reported in several countries, although the fluoroquinolone-resistant clinical strain has not been reported in Indonesia. In the present study, we examined the drug susceptibility and the presence of gyrA mutations in 17 clinical strains of S. typhi isolated from Surabaya, Indonesia, in 2006 (9 strains) and 2008 (8 strains). Although all 9 isolates from 2006 were sensitive to all tested antibiotics and had no mutation in the gyrA gene, all 8 isolates from 2008 were resistant to nalidixic acid and a...

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  Remaining complaints 1 year after treatment for acute Lyme neuroborreliosis; frequency, pattern and risk factors

Conclusion: Remaining complaints are common after neuroborreliosis. The majority of the complaints are subjective. Pre-treatment symptom duration [ge]6 weeks, high pre-treatment CSF cell count, and female gender seem to be risk factors for remaining complaints. Presence of CSF OCBs may also predict a non-favorable outcome, but this should be further studied. Whether subjective and objective complaints are associated with different risk factors is also an issue for future studies. (Source: European Journal of Neurology)

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  [Original articles] Short versus long duration of antibiotic therapy for bacterial meningitis: a meta-analysis of randomised controlled trials in children

Conclusion: This meta-analysis of the rather limited available relevant data could not show differences between short and long-course antibiotic treatment for bacterial meningitis in children. Further research on this issue is required. (Source: Archives of Disease in Childhood)

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  [Clinical] Implications of current recommendations for third-generation cephalosporin use in the WHO Western Pacific Region following the emergence of multiresistant gonococci

To ascertain recommendations for the treatment of gonorrhoea in the WHO Western Pacific Region (WPR) following the emergence of "cephalosporin-resistant" Neisseria gonorrhoeae and to relate these to clinical and laboratory measures directed towards disease and antibiotic resistance control. WHO WPR Gonococcal Antimicrobial Resistance Programme members provided data on the type, dose and source of third-generation cephalosporins recommended for the treatment of gonorrhoea. Ceftriaxone was recommended more widely (11/15 respondents) than cefixime (five centres). No cephalosporins were recommended in three jurisdictions. One other oral (ceftibuten) and injectable (cefodizime) agent was recommended. Uniform (400 mg) doses of cefixime were recommended but ceftriaxone regimens ranged between 125...

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  A nine month old child with retropharyngeal abscess secondary to mastoid abscess presenting as torticollis: a case report

We describe the unusual case of a 9-month-old Caucasian girl with a retropharyngeal abscess secondary to a mastoid abscess who presented with torticollis. The retropharyngeal abscess was caused by pus from the mastoid abscess tracking down under the petrous part of the temporal bone to reach the retropharyngeal space via the fossa of Rosenmuller. We believe that this is the first time that this route of infection has been reported. The patient was treated successfully with 7 days of intravenous ceftriaxone and flucloxacillin followed by oral co-amoxiclav for 7 days, followed by physiotherapy. (Source: Cases Journal)

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  Viridans streptococcal (Streptococcus intermedius) mitral valve subacute bacterial endocarditis (SBE) in a patient with mitral valve prolapse after a dental procedure: The importance of antibiotic prophylaxis

We report a case of S. intermedius SBE in a patient with mitral valve prolapse (MVP). Throughout the patient's life, she received antibiotic prophylaxis for dental procedures and never developed SBE. Because of changes in endocarditis prophylaxis guidelines in 2007, recommending no prophylaxis for dental procedures in patients with MVP, she did not receive prophylaxis for a dental procedure 3 months before admission. The change in prophylaxis recommendations was based on the relatively low incidence of endocarditis with certain cardiac lesions. The recommendations were also based on concern for antibiotic resistance from widespread antibiotic use for antibiotic prophylaxis. There has been no appreciable increase in penicillin resistance, and antimicrobial resistance is not an important con...

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  Tissue-type plasminogen activator prevents abscess formation but does not affect healing of bowel anastomoses and laparotomy wounds in rats with secondary peritonitis

Conclusion: Intraperitoneal rtPA administration consistently and significantly decreased the rate of abscess formation, but did not affect wound healing. Clinical studies investigating its potential as an adjunct in the treatment of secondary peritonitis may be warranted. (Source: Surgery)

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  In vitro activity of the {beta}-lactamase inhibitor NXL104 against KPC-2 carbapenemase and Enterobacteriaceae expressing KPC carbapenemases

Conclusions NXL104 inhibitory activity is unique in terms of spectrum, encompassing class A extended-spectrum β-lactamases, class C enzymes and class A carbapenemases. Given the limited therapeutic options available for infections caused by multiresistant Enterobacteriaceae isolates, NXL104 β-lactamase inhibitor is a promising agent to be used in combination with a β-lactam to protect its antibacterial activity. (Source: Journal of Antimicrobial Chemotherapy)

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  Antimicrobial susceptibility of Streptococcus pneumoniae at a university hospital in Taiwan, 2000-07: impact of modified non-meningeal penicillin breakpoints in CLSI M100-S18

Conclusions With the implementation of the new breakpoints, clinicians may continue to use penicillin for the treatment of non-meningeal pneumococcal infections in preference to other drug classes. However, as isolates with borderline penicillin MICs are increasing, continued surveillance of pneumococcal susceptibility to penicillin will be needed. (Source: Journal of Antimicrobial Chemotherapy)

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  What Are the Presenting Problems of Staphylococcus in Neonates?

Discussion Staphylococcus sp. are gram-positive, catalase-positive cocci that cluster when viewed microscopically. There are 17 species indigenous to humans and 13 colonize humans. Staphylococcus aureus is the only species that produces coagulase. Staphylococcus sp. can be found in almost any environment including high salt, low oxygen, high heat and low moisture. Coagulase-negative Staphylococcus sp. are so common that newborn infants are colonized by 2-4 days of life usually with S. epidermidis and S. haemolyticus. Staphylococcus aureus produces many infections especially pneumonia and surgical wound infections. Humans can be colonized with it especially in mucous membranes and the perineum and axilla. Those with nasal carriage can also transiently carry the organism on their hands, thu...

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  Severe Weil's syndrome complicated by hemolytic anemia

A 48-year-old man presented to our hospital complaining of a 7-day history of sudden onset of fever, chills, nausea, and vomiting. On admission his temperature was 38.7°C, his heart rate was 104 bpm, and his blood pressure was 110/60 mmHg. He presented with jaundice, liver tenderness, intense myalgias, dyspnea with hemoptysis, meningism, coarse crackles on basal and middle pulmonary segments, and a systolic heart murmur. A chest X-ray showed bilateral patchy infiltrates and his electrocardiogram showed tachycardia and T inversion in III and aVL. He was questioned about contact with animals, and recalled being startled by a rat while carrying dry wood in his garden. Blood, cerebrospinal fluid (CSF), and urine samples were taken for analysis, and empirical antibiotic therapy with ceftriaxon...

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  CEFTRIAXONE (Ceftriaxone Sodium) Injection, Solution [Baxter Healthcare Corporation]

Updated Date: Jul 1, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Recalls and Safety Alerts: Update on Precipitate Formation with Ceftriaxone and Calcium-containing Products

FDA is updating earlier recommendations about the interaction between the antibiotic ceftriaxone and intravenous products that contain calcium. In certain circumstances, this interaction can cause dangerous precipitates to form. Ceftriaxone is sold... (Source: Food and Drug Adminstration (FDA): Patient Safety News)

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  Pharmacokinetics of ceftriaxione, a third-generation cephalosporin, in pediatric patients.

Authors: Fukumoto K, Aida S, Oishi T, Ueno K We monitored the serum concentration of ceftriaxone (CTRX) in order to clarify its pharmacokinetics in pediatric patients. Subjects were 21 patients undergoing CTRX therapy (50 mg/kg/d) for pneumonia from January to September 2007. To determine the serum concentration of CTRX and to obtain other laboratory data, blood samples were drawn just before and after drug administration. To clarify the relationship between protein concentration and the protein binding ratio of CTRX in vitro and in vivo, the effect of human albumin on the binding ratio was investigated. Thereafter, the relationship between the protein binding ratio and the concentration of CTRX in pediatric patients was analyzed. There was no significant correlation between age and th...

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  Acute Haemophilus parainfluenzae endocarditis: a case report

Conclusion: We underline the typical presentation of large vegetations in H. parainfluenzae endocarditis, which are associated with embolic phenomena and resulting severity. Although the majority of the few cases reported in the literature are subacute in progress, our case further underlines the possibility that H. parainfluenzae endocarditis may develop rapidly. Thus, awareness of the imaging characteristics of the pathogen may enhance early appropriate diagnosis and therapeutic response. (Source: Journal of Medical Case Reports)

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  Antiretroviral-induced genital ulceration

We report a 45-year-old male with HIV on highly active antiretroviral therapy (HAART), with a viral load of 300, CD4 count of 550, and penile ulcers since 1999. A biopsy of one of the ulcers in 2005 reported changes consistent with herpes simplex virus (HSV) infection; however, the ulcers were unresponsive to multiple courses of acyclovir and intravenous Foscarnet (AstraZeneca, London, UK). His bloodwork argued against rheumatologic causes for the ulcerations, including a negative antinuclear antibody, negative rheumatoid factor, and an erythrocyte sedimentation rate within normal limits. The patient also tested negative for syphilis, hepatitis B, hepatitis C, gonorrhea, and chlamydia. The patient received the following medications without improvement: doxycycline, ceftriaxone, valtrex, an...

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  [Neuroborreliosis.]

Authors: Kaiser R, Fingerle V Neuroborreliosis is easily diagnosed by means of clinical symptoms and laboratory findings. Guiding symptoms are radicular pain and pareses of the extremities and the facial nerve. There is a great number of further less frequently occurring neurological symptoms, which can be attributed to a borrelial infection only by appropriate investigations of the CSF. Radiculitis is cured adequately by oral doxycycline while symptoms of the central nervous system are probably better treated intravenously by ceftriaxone, cefotaxime or penicillin G. Post-Lyme syndrome is a diffuse description of non-specific complaints, which are not the explicit result of a former infection with B. burgdorferi. As further antibiotics do not help and the CSF is unremarkable in most pa...

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  Genetics of chromosomally mediated intermediate resistance to ceftriaxone and cefixime in Neisseria gonorrhoeae.

Authors: Zhao S, Duncan M, Tomberg J, Davies C, Unemo M, Nicholas RA Strains of Neisseria gonorrhoeae with reduced susceptibility to ceftriaxone and cefixime (ceph(I) strains) all contain a mosaic penA allele encoding penicillin-binding protein 2 (PBP 2) with nearly 60 amino acid differences compared to wild type PBP 2, together with a set of resistance determinants (i.e. mtrR, penB, and/or ponA1) that are required for high-level penicillin resistance. To define the individual contributions of these determinants to reduced susceptibility to ceftriaxone and cefixime, we created isogenic strains containing the mosaic penA allele from the ceph(I) strain 35/02 (penA35) together with one or more of the other resistance determinants, and determined the MICs of penicillin G, ceftriaxone, and ...

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  Acute acalculous cholecystitis complicating typhoid fever in an adult patient: A case report and review of the literature

In this report the literature is reviewed and the pathogenesis of the disease is discussed. (Source: Travel Medicine and Infectious Disease)

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  Antimicrobial susceptibility and biochemical patterns of Neisseria gonorrhoeae strains in Vejle area, Denmark

Conclusions Ceftriaxone should be used as the first-line treatment of gonorrhoea in Vejle community area, Denmark, both for infections with proA-producing and proA-negative N. gonorrhoeae isolates, which circulate in the region. None declared. (Source: Journal of the European Academy of Dermatology and Venereology)

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  Nocardia farcinica pericarditis after kidney transplantation despite prophylaxis

L. McPhee, P. Stogsdill, J.P. Vella. Nocardia farcinica pericarditis after kidney transplantation despite prophylaxis.Transpl Infect Dis 2009. All rights reserved A deceased-donor kidney transplant recipient developed purulent pericarditis caused by Nocardia despite trimethoprim[ndash]sulfamethoxazole (TMP[ndash]SMX) prophylaxis for Pneumocystis jirovecii. She was treated empirically with ceftriaxone and amikacin and subsequently underwent sternotomy with drainage of an intrapericardial abscess. Culture and susceptibility data demonstrated Nocardia farcinica, which was susceptible to SMX and amikacin, although resistant to ceftriaxone. Nocardia asteroides, the more common human pathogen, is generally susceptible to third-generation cephalosporins and TMP[ndash]SMX. N. farcinica is rare in ...

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Top Viagra Store

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Indian Meds

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