bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prospective Comparison of Ceftriaxone and Cefotaxime for the Short-Term Treatment of Bacterial Meningitis in Children
Authors: Scholz H. , Hofmann T. , Noack R. , Edwards D.J. , Stoeckel K. 
Published: April 2003

The effectiveness and safety of ceftriaxone and cefotaxime in the short-term treatment of primary bacterial meningitis were compared using a prospective, randomized, multicenter study design. Children between the ages of 6 weeks and 16 years received either ceftriaxone as a single dose (100 mg/kg on the first day followed by 75 mg/kg/day) or cefotaxime as four divided doses (200 mg/kg/day) for 4–7 days. A total of 82 patients (44 ceftriaxone, 38 cefotaxime) with documented bacteria in the CSF were studied. In patients receiving ceftriaxone, full recovery occurred in 79.5% while a further 13.7% recovered with neurologic sequelae. Full recovery was observed in 71.1% of children treated with cefotaxime with sequelae in a further 23.6% (no statistically significant differences between drugs). The time to clinical improvement and resolution of fever (3–4 days) was also similar for both drugs. All but 1 of the 82 patients studied had negative CSF cultures within 24 h of the beginning of therapy consistent with the excellent penetration into the CSF (trough concentrations of 2.7 mg/l for both drugs at the end of therapy). No differences were observed in the incidence of clinically significant adverse events. Ceftriaxone and cefotaxime are both effective in the treatment of bacterial meningitis. Ceftriaxone offers an advantage in ease of administration since it is administered as a single daily dose.
Antibiotic Susceptibility of Stenotrophomonas (Xanthomonas) maltophilia: Comparative (NCCLS Criteria) Evaluation of Antimicrobial Drugs with the Agar Dilution and the Agar Disk Diffusion (Bauer-Kirby) Tests
Authors: Traub Walter H. , Leonhard Birgit , Bauer Dierk 
Published: April 2003

Ninety-six clinical isolates of <i>Stenotrophomonas maltophilia</i> were examined with the agar dilution method for susceptibility to 19 antimicrobial drugs. Doxycycline, cotrimoxazole, timentin, ofloxacin, fosfomycin, and piperacillin + tazobactam, in that order, inhibited the majority of strains. All isolates were resistant to nitrofurantoin. Concurrent disk susceptibility (Bauer-Kirby method) testing, using currently valid NCCLS interpretative criteria for <i>Pseudomonas aeruginosa,</i> uncovered a significant incidence of very major (category I), major (category II), and minor (categories III and IV) discrepancies for aminoglycosides, cephalosporins, chloramphenicol, and piperacillin + tazobactam and ticarcillin + clavulanic acid. Therefore, new interpretative criteria indicative of intermediate (I) susceptibility of <i>S. maltophilia</i> to these various antibiotics were proposed. In addition, new intermediate susceptibility criteria were proposed for the two β-lactam-β-lactamase inhibitor combinations. It was recommended to exclude ciprofloxacin from test batteries against this microorganism due to the wide scatter of minimal inhibitory concentration values and diameters of inhibition zones; the same was true for polymyxin B. It is hoped that the proposed modified, species- specific criteria will improve the clinical utility of laboratory-generated disk antibiograms with respect to the inherently multiple antibiotic-resistant, opportunistic pathogen <i>S. maltophilia.</i>
Surveillance of <i>Pseudomonas aeruginosa</i> in Intensive Care Units: Clusters of Nosocomial Cross-Infection and Encounter of a Multiple-Antibiotic Resistant Strain
Authors: Traub Walter H. , Scheidhauer Ralf , Leonhard Birgit , Bauer Dierk 
Published: April 2003

Serogrouping (determination of O antigens) and bacteriocin typing (based on susceptibility to one or more of 18 bacteriocins) were employed to survey 210 isolates of <i>Pseudomonas aeruginosa</i> from 201 patients in 8 intensive care units (ICU) during an observation period of 18 months. Eighty-eight isolates (41.9%) were nonserogroupable (NT); most common were serogroups O1, O9, O11, and O3. All except 5 isolates (97.6%) were bacteriocin-typable. However, phenotypic variation of bacteriocin susceptibility, in particular the receptor for bacteriocin No. 13, rendered this typing method presumptive as well. Bacteriocin susceptibility profiles were not predictive of serogroup and vice versa. Workup of 19 isolates from 9 patients disclosed phenotypic variation of antibiotic susceptibility in 3 patients, superinfection by a different strain in 4 patients, and persistence (3 months) of the same strain in 2 patients, respectively. Serotyping and bacteriocin susceptibility test data revealed 15 clusters of putative cross-infection of 2 patients each, 8 clusters involving 3 patients each, one outbreak (serogroup NT, bacteriocin profile 777736) involving 4 patients in the pediatric ICU, one outbreak due to a multiple-antibiotic resistant (MAR) strain in the surgical ICU (4 patients, serogroup O12, bacteriocin profile 30400), and two putative outbreaks in the pneumonology ICU involving 6 patients (serogroup NT, bacteriocin profile 777726) and 9 patients (serogroup NT, bacteriocin profile 777736). Pulsed-field gel electrophoresis (PFGE) macrorestriction analysis (<i>Spe</i>I, <i>Xba</i>I) confirmed the pediatric and surgical ICU strains as singular strains. However, the two putative outbreaks in the pneumonology ICU were due to one particular strain which had infected 13 of the 15 patients as determined with the PFGE genotypic method. Isolates comprising the MAR strain of <i>P. aeruginosa</i> were susceptible only to amikacin, fosfomycin, and polymyxin B; the isolates varied in susceptibility to aztreonam and ceftazidime. This MAR strain was susceptible to the bactericidal activity of 65 vol% of fresh defibrinated human blood from donors B, L, and T. Either amikacin (16 µg/ml) or fosfomycin (8 µg/ml) plus blood and amikacin (8 µg/ml) combined with fosfomycin (8 µg/ml) with and without blood consistently killed isolates of the MAR strain, which thus was amenable to antibiotic therapy.
In vitro Activity of Loracarbef against TEM Extended-Spectrum β-Lactamase-Producing <i>Escherichia coli</i> Strains andIts Interaction with the Enzymes
Authors: Prinarakis E.E. , Tzouvelekis L.S. , Legakis N.J. 
Published: April 2003

The in vitro activity of loracarbef was evaluated against <i>Escherichia coli</i> strains producing TEM extended-spectrum β-lactamases (ESBLs). The MICs of loracarbef were lower than those of cefaclor and cephalothin. The antibiotic was active (MICs ≤2 mg/l) against strains producing TEM-6, TEM-8, TEM-10, TEM-16, TEM-26 and TEM-28 β-lactamases. The MICs for TEM-3-, TEM-5- and TEM-24-producing strains were higher (≥ 16 mg/l). Hydrolysis studies indicated that the latter β-lactamases inactivated loracarbef more efficiently than the remaining TEM-type ESBLs examined.
Effect of the 5α-Reductase Inhibitor PNU 156765, Alone or in Combination with Flutamide, in the Dunning R3327 Prostatic Carcinoma Model in Rats
Authors: Zaccheo Tiziana , Giudici Donata , Panzeri Achille , di Salle Enrico 
Published: April 2003

The efficacy of treatment with the 5α-reductase inhibitor PNU 156765 (FCE 28260) was investigated in the Dunning R3327 prostatic tumor in rats. The compound, given orally at the doses of 10 and 50 mg/kg/day, for 8 weeks, reduced the growth of established tumors by 49–50%, an effect similar to that of flutamide at 5 mg/kg/day (46% inhibition). In a further experiment, the combination of PNU 156765 10 mg/kg/day and flutamide 5 mg/kg/day resulted in greater inhibition than either treatment alone (70 vs. 20% in PNU-156765-treated and 51% in flutamide-treated groups). The effect of the combination was similar to that of castration (75% inhibition). Ventral prostate weight was more markedly reduced by PNU 156765 than by flutamide, and combined treatment was as effective as castration. Prostatic dihydrotestosterone content was markedly reduced by PNU 156765 while prostatic testosterone increased. Concomitant treatment with flutamide antagonized the testosterone increase induced by PNU 156765. These data indicate a role for 5α-reductase inhibitors in the therapy of prostate cancer, in combination with antiandrogens, in order to achieve adequate androgen blockade with minimal side effects.
Bactericidal Effect of Levofloxacin on Strains with Equal Susceptibility in anin vitro Urinary Bladder Model
Authors: Takahashi Satoshi , Sano Masato , Nishimura Masahiro , Matsukawa Masanori , Mikami Midori , Hirose Takaoki , Tsukamoto Taiji 
Published: April 2003

The in vitro bactericidal effects of therapeutic concentrations of levofloxacin (LVFX) on clinical isolates of <i>Pseudomonas aeruginosa</i> and <i>Enterococcus faecalis</i> were assessed. Starting from 10<sup>7</sup> CFU/ml, the bacterial count was determined serially during the exposure to LVFX present at concentrations automatically simulated to its clinically achievable urinary levels at the recommended dosage (100 mg 3 times daily). An isolate of <i>P. aeruginosa</i> for which the MIC of LVFX was 16 µg/ml was completely eradicated after 10 h of exposure to LVFX. On the other hand, 40 h of exposure to LVFX were required for complete eradication of an isolate of <i>E. faecalis</i> with equal susceptibility, although the bacterial count was rapidly reduced to 10<sup>2</sup> CFU/ml in the early phase of the exposure. It was concluded that LVFX exerts a more potent bactericidal effect on <i>P. aeruginosa</i> than on <i>E. faecalis</i> despite a similar susceptibility of these organisms to LVFX.
Pharmacokinetics of Cefodizime in Patients with Various Degrees of Renal Failure
Authors: Loffreda A. , Lampa E. , Lucarelli C. , Amorena M. , Contaldi C. , Calderaro V. , Rossi F. 
Published: April 2003

The pharmacokinetics of cefodizime, a new expanded-spectrum cephalosporin for parenteral use, was studied in 45 subjects with various degrees of renal failure. Patients were divided into five groups according to the following creatinine clearances: group I >80 ml/min; group II <80–30 ml/min; group III <30–15 ml/min; group IV <15–5 ml/min and group V <5 ml/min. Cefodizime was administered as a 1 g i.v. bolus. Plasma and urinary concentrations of cefodizime were determined by high-performance liquid chromatography, using for detection UV absorbance. The following pharmacokinetic parameters were calculated: maximum plasma concentration (C<sub>5 min</sub>), area under the plasma concentration-time curve (AUC), terminal half-life (T<sub>1/2</sub>), terminal rate constant (λ-z), total clearance (Cl<sub>t</sub>), volume of distribution (V<sub>d</sub>), mean residence time (MRT), urine data-derived terminal half-life (T<sub>1/2 r</sub>), renal clearance (Cl<sub>r</sub>). The results of this study showed that renal failure induced changes in cefodizime pharmacokinetics. Our data demonstrated a close correlation between degree of renal impairment and pharmacokinetic changes. The maximum plasma concentration (C<sub>5 min</sub>) was higher in patients with renal failure; T<sub>1/2</sub> was increased; AUC also increased from 470.40 ± 17.80 mg·h/l in the control group to 1,562.30 ± 170.8 mg·h/l in group V. Moreover, no side effect was observed after treatment with 1 g i.v. of cefodizime. Although renal failure induces significant changes of cefodizime pharmacokinetics, the drug was well tolerated and only in patients with severe renal insufficiency we advise to monitor the interval dose of cefodizime or adjust doses to renal function.
In vitro Activity of Trovafloxacin (CP 99,219), a New Fluoroquinolone against Hospital Isolates
Authors: Ling T.K.W. , Liu E.Y.M. , Cheng A.F.B. 
Published: April 2003

The susceptibility of 492 Enterobacteriaceae, 227 other gram-negative bacteria, 448 gram-positive bacteria and 108 anaerobic organisms was determined by the agar dilution method against trovafloxacin and other antibiotics. Trovafloxacin was highly active against most of the Enterobacteriaceae including Enterobacter spp. and Citrobacter spp. [minimum inhibitory concentration (MIC)<sub>90</sub> <1 mg/l], Acinetobacter spp. and Pseudomonas aeruginosa (MIC<sub>90</sub> = 0.25 and 2 mg/l, respectively). The antimicrobial activity was extended to the gram-positive bacteria including streptococci, Streptococcus pneumoniae, coagulase-negative staphylococci and methicillin-sensitive Staphylococcus aureus with MIC<sub>90</sub> <1 mg/l. Enterococci and methicillin-resistant S. aureus were inhibited (MIC<sub>90</sub> = 2 mg/l; sparfloxacin and ciprofloxacin were 16 and 64 mg/l, respectively). Almost all anaerobic organisms were inhibited by trovafloxacin (MIC<sub>90</sub> = 1 mg/l).
Treatment of Malaria tropica with a Fixed Combination of Rifampicin, Co-Trimoxazole and Isoniazid: A Clinical Study
Authors: Goerg H. , Ochola S.A. , Goerg R. 
Published: April 2003

The treatment of malaria tropica is becoming difficult because of the increasing drug resistance rates of Plasmodium falciparum against several of the currently available antimalarias. A fixed combination of rifampicin, co-trimoxazole and isoniazid (Cotrifazid<sup>TM</sup>, CF) was found to be highly effective for the treatment of malaria tropica. The aim of the present study in Kenya was to scrutinize this finding in a 14-day trial. Patients with malaria tropica were given in an open, double-arm randomized study CF for 5 days, or chloroquine or pyrimethamine/sulphadoxine as the control. Because of an apparently better activity and tolerance of CF, the randomization had to be stopped after the enrollment of 50 patients. A total of 61 patients in both groups (35 of them between 2 months and 6 years of age) were available for final analysis. All 41 patients treated with CF, originally positive in their blood smears, turned negative; in 2 cases blood smear positivity reappeared on day 14. There were 7 failures in the control group, 4 of them a primary one. Four of those failures were turned negative with CF, 2 failed with CF also, and 1 disappeared. The tolerance of CF was excellent even in infants. In our experience, CF is very well suited for the treatment of malaria tropica, also in cases of apparent drug resistance of P. falciparum against other antimalarials, and even in severe cases of the disease.
Phase I Pharmacokinetic Study of a New 3-Azinomethyl-Rifamycin (Rifametane) as Compared to Rifampicin
Authors: Potkar C. , Gogtay N. , Gokhale P. , Kshirsagar N.A. , Ajay S. , Cooverji N.D. , Bruzzese T. 
Published: April 2003

An open randomized cross-over study was conducted in 8 healthy male volunteers to study the pharmacokinetic pattern and the safety of a 300-mg single oral dose of a new 3-azinomethyl-rifamycin (USAN rifametane, SPA-S-565) compared with 300 mg of conventional rifampicin. The pharmacokinetic profiles of rifametane were significantly more favorable than those of rifampicin. The serum peak value was 7.82 µg/ml for rifametane and 4.04 µg/ml for rifampicin (p < 0.001); the elimination half-life was 10.58 h for rifametane and 1.89 h for rifampicin (p < 0.001); area under the serum concentration curve from 0 to infinity was 142.3 µg·h/ml for rifametane and 19.9 µg·h/ml for rifampicin (p < 0.001); the mean residence time was 18.05 h for rifametane and 3.93 h for rifampicin (p < 0.001). Rifametane showed a good safety profile after the 300-mg single oral dose. Three volunteers developed a mild headache, metallic taste and slightly elevated temperature for 3–4 h, which subsided without medication. Clinically or statistically significant changes in laboratory parameters were not found between baseline and posttreatment values.
Low-Dose Amphotericin B Lipid Complex for the Treatment of Persistent Fever of Unknown Origin in Patients with Hematologic Malignancies and Prolonged Neutropenia
Authors: Martino Rodrigo , Subirá Maricel , Domingo-Albós Andreu , Sureda Anna , Brunet Salut , Sierra Jordi 
Published: April 2003

We studied the safety of low-dose amphotericin B lipid complex (ABLC, at 1 mg/kg/day) in 30 persistently febrile (>38°C for at least 5 days or with recurrent fever after 3 days of apyrexia) and neutropenic (<0.5 × 10<sup>9</sup>/l) adult patients with hematologic malignancies. The median age was 45 years (range 18–67), most (60%) had an acute leukemia and all had fever of unknown origin (FUO). The total duration of neutropenia was a median of 17 days (range 9–33), and the total number of days with fever 10 days (range 6–39). Seven patients experienced mild-to- moderate infusion-related adverse events (IRAE). The serum creatinine and urea increased from baseline to end of therapy in 76 and 63% of cases, but the maximum levels reached were <130 µmol/l and <11 mmol/l, respectively, in all cases. Liver enzymes showed modest but significant increases in most patients during therapy, while bilirubin decreased in 74% of cases. Response to treatment (defervescence within 6 days without developing a fungal or nonfungal infection) was seen in 22 cases (73%, 95% CI 58–89%), while 8 episodes were considered treatment failures: 2 due to persistent FUO, 1 withdrew due to IRAE, 2 developed nonfungal infections and 3 developed a presumed or definite invasive mycosis. We conclude that low-dose ABLC is very safe and well tolerated and seems as effective as c-AmB for this indication. Thus, randomized trials at this dose level appear justified to demonstrate any real benefit over c-AmB or other lipid formulations for the treatment of FUO in neutropenic patients.
Killing of Gram-Negative Bacteria by Ciprofloxacin within both Healthy Human Neutrophils and Neutrophils with Inactivated O<sub>2</sub>-Dependent Bactericidal Mechanisms
Authors: Cantón E. , Peman J. , Cabrera E. , Velert M. , Orero A. , Pastor A. , Gobernado M. 
Published: April 2003

The intraphagocytic killing of <i>Escherichia coli, Serratia marcescens, Pseudomonas aeruginosa,</i> and <i>Salmonella typhi</i> by ciprofloxacin (0.1, 1 and 5 μg/ml) within human neutrophils with intact and impaired (by phenylbutazone treatment) O<sub>2</sub>-dependent killing mechanisms was studied and compared with the extracellular killing in the same medium of the intraphagocytic killing, but omitting neutrophils. The MIC/MBC of ciprofloxacin in vitro (assays performed according to NCCLS specifications) were: 0.015/0.06 for <i>E. coli,</i> 0.12/32 for <i>S. marcescens,</i> 1/16 for <i>P. aeruginosa,</i> and 0.007/0.06 for <i>S. typhi.</i> Ciprofloxacin showed bactericidal activity both extracellular and within phenylbutazone-treated and untreated neutrophils. The minimum concentration of ciprofloxacin to kill 90% of phagocytosed bacteria within neutrophils with normal O<sub>2</sub>-dependent killing power after 30 min was: 0.1 μg/ml for <i>E. coli,</i> and <i>S. typhi,</i> 1 μg/ml for <i>P. aeruginosa,</i> and 5 μg/ml for <i>S. marcescens.</i> In contrast, exposure for 60 min was required to reach this percentage within phenylbutazone treated neutrophils. The minimum concentration to kill 90% of extracellular bacteria after 30 min was: 0.1 μg/ml for <i>E. coli, P. aeruginosa</i> and <i>S. typhi,</i> and 5 μg/ml, for <i>S. marcescens.</i> A positive interaction between ciprofloxacin and the O<sub>2</sub>-dependent mechanisms of phagocytes was found. The reactive oxygen metabolites produced in the respiratory burst did not affect the intraphagocytic activity of ciprofloxacin. Phenylbutazone treatment of phagocytes would be a good experimental model to study the intraphagocytic killing of drugs in situations such as AIDS and chronic granulomatous disease where inefficient oxidative mechanisms of neutrophils exist.
Ionic Binding of <sup>3</sup>H-Gentamicin and Short-Time Bactericidal Activity of Gentamicin against <i>Pseudomonas aeruginosa</i> Isolates with Different Lipopolysaccharide Structures
Authors: Saika Takeshi , Hasegawa Miyuki , Kobayashi Intetsu , Nishida Minoru 
Published: April 2003

The clinical isolates of <i>Pseudomonas aeruginosa</i> can be roughly classified into long- and short-LPS strains and LPS-deficient strains. Ionic binding of <sup>3</sup>H-gentamicin was the highest in the long-LPS strains followed in descending order by short-LPS and LPS-deficient strains. However, PAC605 strain, completely lacking in the repeated units of O-polysaccharide and also lacking in some of the neutral sugar residues of the core oligosaccharide region, highly bound to <sup>3</sup>H-gentamicin and it is suggested that the negatively charged sites on the deep-core oligosaccharide region and/or on lipid A participated in the binding to <sup>3</sup>H-gentamicin. This manner of binding may be also applied to <i>P. aeruginosa</i> No. 45 (LPS-deficient), a clinical isolate.
Adequate Macrolide Treatment Schedules for Uterine Cervicitis Caused by <i>Chlamydia trachomatis</i>
Authors: Mikamo Hiroshige , Sato Yasumasa , Hayasaki Yoh , Tamaya Teruhiko 
Published: April 2003

To evaluate in vivo efficacy of macrolides; erythromycin (EM) and clarithromycin (CAM), in the different treatment schedules of <i>Chlamydia trachomatis</i> uterine cervicitis im women. Cervical <i>C. trachomatis</i> was detected by the polymerase chain reaction. EM was orally administered to 8, 15 and 18 Japanese patients, at a dosage of 600 mg, t.i.d. for 5, 7 and 14 days, respectively. CAM was orally administered to 10, 26 and 19 Japanese patients at a dosage of 400 mg, b.i.d. for 5, 7 and 14 days, respectively. The eradication rate and the recurrence rate in the different treatment schedules of <i>C. trachomatis</i> were evaluated. The eradication rates after 5, 7 or 14 days of treatment with EM were 1/8, 8/15 or 13/18, respectively. The recurrence rates after 5, 7 or 14 days of treatment with EM were 1/1, 3/8 or 2/13, respectively. On the other hand, the eradication rates after 5, 7 or 14 days of treatment with CAM were 5/10, 26/26 or 19/19, respectively. The recurrence rates after 5, 7 or 14 days of treatment with CAM were 3/5, 0/26 or 0/19, respectively. A 7-day treatment with CAM would be adequate and effective for <i>C. trachomatis</i> uterine cervicitis.