Cephazolin Treatment of Pneumococcal Pneumonia and Urinary Tract Infections

1975 ◽  
Vol 20 (5) ◽  
pp. 248-254 ◽  
Author(s):  
M. Kilpatrick ◽  
T. C. Cesario ◽  
L. Thrupp ◽  
J. G. Tilles
Keyword(s):  
Renal Function ◽  
Half Life ◽  
Pneumococcal Pneumonia ◽  
Peak Level ◽  
Serum Levels ◽  
Peak Serum Level ◽  
E Coli ◽  
Serial Serum ◽  
The Mean ◽  
Tract Infections

Ten cases of pneumococcal pneumonia were treated with cephazolin 500 mg. q8h for at least 5 days. In every case therapy was accompanied by clinical improvement and eradication of the organism. Ten patients with E. coli bacteriuria (5 symptomatic) were treated with cephazolin 500 mg. q12h for 7 to 10 days. In every case the pathogen was eliminated during therapy but in one case bacteriologic relapse occurred following cessation of therapy. In 10 cases of bacteriuria caused by P. mirabilis, Klebsiella sp, Enterobacter, and Enterococcus, the urine became sterile during treatment, but relapse was common. Initial and final creatinine clearances obtained in 29 patients who received an average of 12.9 g. of cephazolin showed no tendency toward loss of renal function. Serial serum levels of cephazolin were determined following the first 500 mg. dose in 18 patients. The peak serum level occurred at one hour with a serum half life of approximately 2.2 hours. For 13 of these 18 patients serial serum levels were also obtained following the last dose of cephazolin. At this time the mean peak level occurred at 2 hours but again the serum half life was approximately 1.9 hours.

scholarly journals Urinary Excretion and Bactericidal Activities of a Single Oral Dose of 400 Milligrams of Fleroxacin versus a Single Oral Dose of 800 Milligrams of Pefloxacin in Healthy Volunteers

1998 ◽  
Vol 42 (7) ◽  
pp. 1659-1665 ◽  
Author(s):  
Kurt G. Naber ◽  
Ursula Theuretzbacher ◽  
Martina Kinzig ◽  
Orlin Savov ◽  
Fritz Sörgel
Keyword(s):  
Oral Dose ◽  
Healthy Volunteers ◽  
Single Oral Dose ◽  
E Coli ◽  
Wide Range ◽  
The Mean ◽  
Bactericidal Activities ◽  
Tract Infections ◽  
Time Kill ◽  
Randomized Crossover Study

ABSTRACT Twelve healthy volunteers participated in this randomized crossover study to compare the concentrations and recovery levels of fleroxacin and pefloxacin in urine and to assess their bactericidal activities against 12 strains of urinary pathogens with different susceptibilities over a wide range of MICs. The volunteers received a single oral dose of 400 mg of fleroxacin or 800 mg of pefloxacin. The mean cumulative renal excretion of unchanged fleroxacin,N-demethyl-fleroxacin, and N-oxide-fleroxacin accounted for 67, 7, and 6% of the total dose, respectively. The total urinary recovery of pefloxacin and the active metabolite norfloxacin was 34%. In the time-kill and the urinary bactericidal titer (UBT) studies, only the subjects’ urine not supplemented with broth was used. With most tested organisms and both quinolones it took more than 8 h to achieve a reduction in CFU of 99.9% (3 log units). Overall, there was a good correlation between UBTs and MICs for the strains. Against Escherichia coli ATCC 25922 the median UBTs were similar for both antibiotics and at least 1:8 for 96 h; against the E. coli strain for which the MIC was 0.5 μg/ml the UBT was at least 1:4 for 48 h. The UBTs of both drugs against Klebsiella pneumoniae were at least 1:16 for 72 h. The UBTs for Staphylococcus aureus (the MIC for which was 16 μg/ml) of both antibiotics were low, and in some of the samples, no bactericidal titers were observed. UBTs for Proteus mirabilis of pefloxacin are significantly higher than those of fleroxacin. For Pseudomonas aeruginosa the median UBTs were present for the 24-to-48-h interval. The same is true forEnterococcus faecalis. Against Staphylococcus saprophyticus, UBTs were present for at least 48 h with both quinolones. Overall, a single oral dose of 400 mg of fleroxacin exhibits UBTs comparable to those of 800 mg of pefloxacin. Therefore, it may be expected that half of the dose of fleroxacin gives comparable results in the treatment of urinary tract infections; this should be substantiated in comparative clinical trials.

scholarly journals Therapeutic Drug Monitoring of Levoffoxacin in an Obese Adolescent: A Case Report

2020 ◽  
Vol 25 (3) ◽  
pp. 261-265 ◽  
Author(s):  
Alexandra M. Hanretty ◽  
Wayne S. Moore ◽  
Arun Chopra ◽  
Jeffrey J. Cies
Keyword(s):  
Half Life ◽  
Clinical Status ◽  
Total Duration ◽  
Pediatric Intensive Care ◽  
Peak Level ◽  
Serum Levels ◽  
Therapeutic Drug ◽  
Morbidly Obese ◽  
Obese Adolescent ◽  
Antimicrobial Regimen

OBJECTIVES To describe the pharmacokinetics of levofloxacin in an obese adolescent patient in the pediatric intensive care unit. METHODS A single-patient medical record review was conducted. RESULTS A 168-kg, 15-year-old female with past medical history of Prader-Willi syndrome and asthma initially presented with respiratory distress secondary to asthma exacerbation. She failed non-invasive ventilation and was subsequently intubated for respiratory failure and progressed to high-frequency oscillatory ventilation. On hospital day 1 (HD 1) an infectious workup was begun because of a fever, worsening clinical status, and initiation of vasopressors and an empiric antimicrobial regimen of cefepime and clindamycin. The urine culture subsequently grew Escherichia coli and the respiratory culture grew Pseudomonas aeruginosa. She continued to be febrile, which was thought to be due to an intra-abdominal abscess. On HD 14, the antimicrobial regimen was changed to levofloxacin because of continued fevers and no significant clinical improvement. Levofloxacin was initiated at 1000 mg IV every 24 hours. Levofloxacin serum levels were obtained at 0.5, 3.5, and 11.5 hours after infusion, which were 8.61, 5.76, and 2.7 mg/L, respectively. These concentrations translated into a peak level of 8.79 mg/L, a half-life of 6.4 hours, and an AUC of 80 mg·hr/L, which are discordant from the expected peak of 16 mg/L, a half-life of 8 hours, and an AUC of 120 mg·hr/L. Based on these values, the levofloxacin regimen was adjusted to 1000 mg IV every 12 hours, and repeat levels 0.5, 3.5, and 11.5 hours after infusion were 9.91, 6.56, and 3.27 mg/L, respectively, corresponding to a peak of 10.5 mg/L, a half-life of 5.18 hours, and an AUC of 200 mg·hr/L. After the adjustment in levofloxacin regimen, she became afebrile, WBC resolution and improvement in her overall clinical status, and she received a total duration for levofloxacin of 21 days. CONCLUSION A levofloxacin regimen of 1000 mg IV every 12 hours was successful in providing for an appropriate AUC exposure and was associated with a successful clinical outcome in this morbidly obese adolescent.

Drug Interaction between Rifampicin and Cotrimoxazole in Patients with Tuberculosis

1991 ◽  
Vol 10 (6) ◽  
pp. 419-421 ◽  
Author(s):  
R.S. Bhatia ◽  
R. Uppal ◽  
R. Malhi ◽  
D. Behera ◽  
S.K. Jindal
Keyword(s):  
Drug Interaction ◽  
Half Life ◽  
Serum Levels ◽  
Antitubercular Therapy ◽  
The Mean ◽  
Plasma Half Life

1 Patients ( n = 15) who were admitted with complications of tuberculosis, were given antitubercular therapy (ATT) with rifampicin (RIF), for a minumum period of 15 d, and cotrimoxazole (CTZ), concurrently, for 5-10 d. 2 The serum RIF levels were measured before the start of CTZ treatment and at the end of its administration. 3 The plasma half-life ( t½) of RIF increased significantly from 1.92 ± 0.57 h to 2.31 ± 0.134 h after CTZ treatment. 4 The mean serum levels of RIF increased significantly at 4 and 6 h after CTZ administration.

scholarly journals FRACTURES

2015 ◽  
Vol 22 (07) ◽  
pp. 954-958
Author(s):  
Nasir Zulfiqar ◽  
Hamid Mahmood ◽  
Ghazia Irfan ◽  
Ammara Waqar ◽  
Nadeem Iqbal
Keyword(s):  
Vitamin D ◽  
Renal Function ◽  
Serum Levels ◽  
Low Energy ◽  
Time Interval ◽  
Target Level ◽  
Recommended Dosage ◽  
Vitamin D Levels ◽  
The Mean ◽  
25 Oh Vitamin D

To find out the effect in increase in serum 25(OH) vitamin D levels aftersupplementation with 1000 IU/day of vitamin D in patients with low vitamin D levels and otherfactors which may affect the increase in vitamin D levels. Study Design: Retrospective study.Period: January 2013 and June 2014. Setting: Ch. Rehmat Ali Trust Teaching Hospital in theLahore. Methods: The study included patients > 50 years with a low-energy fracture and avitamin D level < 25 nmol/l. Results: 85 patients were included, mean basal 25(OH) vitamin Dlevel was 22 nmol/l. After a mean of 10 weeks, the mean increase in vitamin D was 49.5 nmol/l.Only 45.1% reached the target level of > 50 nmol/l. The increase was correlated with the basallevel of vitamin D (p < 0.05), and the time interval between the two vitamin D measurements(p < 0.05) and was inversely related to body weight (p < 0.05), but was not related to age,gender or renal function. Conclusions: We found that the generally recommended dosage of1000 IU of vitamin D per day resulted in suboptimal serum levels after ten weeks of treatment inmore than half of the patients. The increase in vitamin D levels was higher in patients with lowbody weight and in patients with very low basal vitamin D levels. These data suggest that thesepatients should initially be treated with higher dosages of vitamin D. If not possible, vitamin Dmeasurements should be performed after at least six months of supplementation with dosageadjustment.

Absorption of Penicillin V from Mixture Formulations. Comparison of Potassium and Benzathine Salts

1981 ◽  
Vol 9 (3) ◽  
pp. 189-190 ◽  
Author(s):  
Markku Heikinheimo ◽  
Tapani Hovi
Keyword(s):  
Single Dose ◽  
Serum Level ◽  
Potassium Salt ◽  
Absorption Rate ◽  
Peak Level ◽  
Serum Levels ◽  
Dose Administration ◽  
Level Curves ◽  
The Mean ◽  
Adult Volunteers

The absorption rate and serum level curves of two commercial phenoxymethylpenicillin mixture preparations were compared in adult volunteers. Both the potassium salt (Primcilliri®) and the benzathine salt (V-Pen ped forte®) of V-penicillin were rapidly absorbed and the mean peak serum levels were obtained with both preparations within the first hour after single dose administration. The mean peak level obtained with the potassium salt was several-fold higher (p < 0.001) and was also reached within a shorter time than that of the benzathine preparation. These results confirm the earlier evidence, obtained with other formulae, for the superior bioavailability of the potassium salt of V-penicillin as compared to most other derivatives used in V-penicillin mixtures.

Pharmacokinetic Comparison of Intravenous and Oral Chloramphenicol in Patients with Haemophilus in fluenzae Meningitis

PEDIATRICS ◽  
1981 ◽  
Vol 67 (5) ◽  
pp. 656-660
Author(s):  
Ram Yogev ◽  
William M. Kolling ◽  
Tommy Williams
Keyword(s):  
Serum Level ◽  
Oral Administration ◽  
Intravenous Administration ◽  
Half Life ◽  
Peak Serum ◽  
Peak Serum Level ◽  
Wide Range ◽  
Csf Levels ◽  
The Mean ◽  
Intravenous And Oral Administration

The pharmacokinetics of chloramphenicol following intravenous and oral administration were studied in 14 infants with Haemophilus influenzae meningitis. Following five days of treatment with intravenous chloramphenicol (100 mg/kg/day every six hours), oral chloramphenicol was substituted at the same dose. Multiple serum levels of chloramphenicol were determined after an intravenous dose on day 4 and after an oral dose on day 10. CSF levels were measured six hours after intravenous or oral chloramphenicol dose on those days (CSF trough). Following intravenous administration, the mean peak serum level of 15.0 µ/g ml was reached at 45 minutes. In comparison, after oral chloramphenicol in the same dosage, the mean peak serum level of 18.5 µg ml was achieved at two to three hours. The mean serum half-life of the drug (6.5 hours) was significantly longer after oral administration than after intravenous chloramphenicol (4.0 hours) (P .001). The increased serum half-life following orally administered chloramphenicol was occasionally associated with drug accumulation. In addition, mean trough CSF levels were somewhat higher when the patient received oral medication (6.6 µg/ml) compared to intravenous administration (4.2 µ/ml) (P .001). For any treatment regimen for H influenzae meningitis that includes a period of oral chloramphenicol therapy the patient should be hospitalized to ensure compliance. Because of the wide range of individual variation in serum half-life that may result in accumulation, periodic monitoring of serum chloramphenicol levels is also recommended.

scholarly journals Antibiotic Sensitivity Pattern of Uropathogens in Diabetic Women with Asymptomatic Bacteriuria

2020 ◽  
Vol 9 (2) ◽  
pp. 40-144
Author(s):  
Nadeem Islam Sheikh ◽  
Ambreen Zahoor ◽  
Mehreen Baber ◽  
Zaidan Idrees Choudhary
Keyword(s):  
Asymptomatic Bacteriuria ◽  
Antibiotic Sensitivity ◽  
Sensitivity Testing ◽  
E Coli ◽  
Common Organism ◽  
Sensitivity Pattern ◽  
The Mean ◽  
Tract Infections ◽  
Type 2 Diabetic

Background: More than 150 million people around the globe are diagnosed with urinary tract infections every year. Failure to treat these infections with proper antibiotics can lead to serious complications. The objective of this study was to investigate antibiotic sensitivity and resistance pattern of urinary isolates in type-2 diabetic women with asymptomatic bacteriuria. Material and Methods: This cross-sectional descriptive study was conducted at the HBS General Hospital, Islamabad, from March 2017 to August 2019. A total of 270 females with the diagnosis of type-2 diabetes mellitus were included in the study. Uropathogens were isolated from urine samples and antibiotic sensitivity testing was conducted. Demographic and clinical information was recorded on a pre-designed proforma. The data was analyzed using SPSS version 20. Results: The mean age of the study sample was 50 years (SD ± 5.5) while the mean HbA1c levels were 8.98 g/dL (SD ± 0.8 g/dl). Uropathogens were found in the urine cultures of 106 (39.3%) patients. Extended Spectrum Beta-Lactamase producing (ESBL) Escherichia coli (E. coli) was the most common organism (n=46, 43.4%) which was sensitive to tazobactam, tazocin and co-trimoxazole. Nitrofurantoin was the most effective antibiotic with 62.5% isolates sensitive to it. All of the pathogens were resistant to ciprofloxacin. Conclusions: Asymptomatic bacteriuria is common in type-2 diabetic women with ESBL E. Coli being the most common organism isolated from urine cultures. There is a significant resistance to antibiotics among the uropathogens isolated from these patients.

scholarly journals Antibiotic Resistance and Bacteria in Urinary Tract Infections in Pediatric Patients

2021 ◽  
Author(s):  
Yakup Çağ ◽  
Demet Hacıseyitoğlu ◽  
Abdurrahman Avar Özdemir ◽  
Yasemin Çağ
Keyword(s):  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Age Groups ◽  
Female Gender ◽  
E Coli ◽  
Enterococcus Spp ◽  
The Mean ◽  
Tract Infections ◽  
Resistance Rates

Objective: Antibiotic resistance against bacterial pathogens associated with urinary tract infections (UTI) is rapidly increasing worldwide. In this study, we aimed at determining the causative microorganisms in children under 17 years of age diagnosed with UTI in our hospital and the antibiotic resistance rates of these causes. Methods: We isolated and retrospectively analyzed 4801 urine samples of children under 17 years old who presented with bacterial growth in their urine cultures. The isolated bacteria and their antibiotic resistance profiles were statistically analyzed. Results: Most (2001/77.2%) of 2592 patients included in the study were female and the mean age and median interquartile range (IQR) was 55 (12-98) months. Except for the neonatal period, the female gender was predominant in all age groups (p<0.0001). The most frequently isolated bacteria included Escherichia coli (67.7%), Klebsiella spp. (10.7%), and Enterococcus spp. (8.8%). The most and least resistant antibiotics were ampicillin (66.6%) and meropenem (0.3%) for E. coli, respectively. Although resistance of E. faecalis to ampicillin and ciprofloxacin is at a low level, E. faecium is much more resistant to these antibiotics (p<0.0001). Conclusion: It is important that each center determines its own resistant antibiotics so as to guide empirical treatment. Re-evaluating each antibiotic that is started to be used empirically according to the results of culture and sensitivity in addition to switching to a suitable antibiotic would be very effective in reducing resistance rates.

DMSA-scintigraphy in paediatrics: Is the evaluation of the geometric mean necessary for the calculation of the differential renal function?

2001 ◽  
Vol 40 (04) ◽  
pp. 107-110 ◽  
Author(s):  
B. Roßmüller ◽  
S. Alalp ◽  
S. Fischer ◽  
S. Dresel ◽  
K. Hahn ◽  
...  
Keyword(s):  
Renal Function ◽  
Geometric Mean ◽  
Region Of Interest ◽  
Posterior View ◽  
Renal Abnormality ◽  
Anterior View ◽  
Differential Renal Function ◽  
The Mean ◽  
The Right ◽  
To Receive

SummaryFor assessment of differential renal function (PF) by means of static renal scintigraphy with Tc-99m-dimer-captosuccinic acid (DMSA) the calculation of the geometric mean of counts from the anterior and posterior view is recommended. Aim of this retrospective study was to find out, if the anterior view is necessary to receive an accurate differential renal function by calculating the geometric mean compared to calculating PF using the counts of the posterior view only. Methods: 164 DMSA-scans of 151 children (86 f, 65 m) aged 16 d to 16 a (4.7 ± 3.9 a) were reviewed. The scans were performed using a dual head gamma camera (Picker Prism 2000 XP, low energy ultra high resolution collimator, matrix 256 x 256,300 kcts/view, Zoom: 1.6-2.0). Background corrected values from both kidneys anterior and posterior were obtained. Using region of interest technique PF was calculated using the counts of the dorsal view and compared with the calculated geometric mean [SQR(Ctsdors x Ctsventr]. Results: The differential function of the right kidney was significantly less when compared to the calculation of the geometric mean (p<0.01). The mean difference between the PFgeom and the PFdors was 1.5 ± 1.4%. A difference > 5% (5.0-9.5%) was obtained in only 6/164 scans (3.7%). Three of 6 patients presented with an underestimated PFdors due to dystopic kidneys on the left side in 2 patients and on the right side in one patient. The other 3 patients with a difference >5% did not show any renal abnormality. Conclusion: The calculation of the PF from the posterior view only will give an underestimated value of the right kidney compared to the calculation of the geometric mean. This effect is not relevant for the calculation of the differntial renal function in orthotopic kidneys, so that in these cases the anterior view is not necesssary. However, geometric mean calculation to obtain reliable values for differential renal function should be applied in cases with an obvious anatomical abnormality.

Plasma Thrombospondin as an Indicator of Intravascular Platelet Activation in Patients with Vasculitis

1987 ◽  
Vol 58 (03) ◽  
pp. 850-852 ◽  
Author(s):  
M B McCrohan ◽  
S W Huang ◽  
J W Sleasman ◽  
P A Klein ◽  
K J Kao
Keyword(s):  
Platelet Activation ◽  
Plasma Levels ◽  
Half Life ◽  
Degradation Products ◽  
Plasma Concentrations ◽  
Primary Source ◽  
Positive Correlation ◽  
Activation Marker ◽  
Fibrin Degradation Products ◽  
The Mean

SummaryThe use of plasma thrombospondin (TSP) concentration was investigated as an indicator of intravascular platelet activation. Patients (n = 20) with diseases that have known vasculitis were included in the study. The range and the mean of plasma TSP concentrations of patients with vasculitis were 117 ng/ml to 6500 ng/ml and 791±1412 ng/ml (mean ± SD); the range and the mean of plasma TSP concentrations of control individuals (n = 33) were 13 ng/ml to 137 ng/ml and 59±29 ng/ml. When plasma TSP concentrations were correlated with plasma concentrations of another platelet activation marker, β-thromboglobulin (P-TG), it was found that the TSP concentration inei eased exponentially as the plasma β-TG level rose. A positive correlation between plasma levels of plasma TSP and serum fibrin degradation products was also observed. The results suggest that platelets are the primary source of plasma TSP in patients with various vasculitis and that plasma TSP can be a better indicator than β-TG to assess intravascular platelet activation due to its longer circulation half life.

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