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Biomedical subjects

A Micozzi

Publications and source records attributed to A Micozzi.

At least 55 records · Page 3Linked to original sources
PubMed1989

Teicoplanin in the treatment of gram-positive-bacterial endocarditis.

Intravenous teicoplanin has been used to treat 23 cases of gram-positive-bacterial endocarditis, usually with 3 to 7 mg/kg every 12 h on the first day, followed by 3 to 7 mg/kg every 24 h. For some cases (staphylococcal and enterococcal endocarditis), the dosage was 8 to 14.4 mg/kg per day and/or other antibiotics were given. The mean duration was 48.2 days (range, 23 to 130 days). Of 23 patients, 21 (91.3%) had negative cultures or were cured. A total of 18 patients were treated with teicoplanin alone; of these, 4 had surgery, and all (except 2 who relapsed) were cured. Teicoplanin was combined with one or more antibiotics in five cases; in all cases appropriate cultures were negative, but three patients died during therapy or follow-up. Mild renal impairment was seen in two patients; both were receiving teicoplanin in combination with an aminoglycoside. We conclude that intravenous teicoplanin administered once a day at doses of 7 to 14 mg/kg per day is well tolerated, easy to administer, and may represent an efficacious therapy for gram-positive-bacterial endocarditis.

Anti-Bacterial Agents↗
PubMed1988

Efficacy of teicoplanin as antimicrobial treatment of severe nosocomial infections caused by gram-positive bacteria: a preliminary study.

We used single daily intravenous teicoplanin as therapy for 12 severe nosocomial infections caused by gram-positive bacteria. A daily dosage of 3-6 mg/kg was usually adopted; however, in selected cases the dosage was increased to 8-9.5 mg/day on the basis of serum bactericidal monitoring. Most of these infections were life-threatening and included ventriculitis/meningitis (3 cases), sepsis (3 cases), mediastinitis (1 case) and extensive burn wound infection (1 case). Staphylococcus aureus was by far the most frequent pathogen and methicillin-resistant strains were isolated in 7 out of 9 infections caused by this organism. The remaining isolates were Staphylococcus epidermidis, JK Corynebacterium, Streptococcus agalactiae and Propionilbacterium acnes. Additional antibiotics were used in 5 cases for concomitant gram-negative bacillus etiology (2 cases), granulocytopenia (2 cases), superinfection (1 case). Overall a clinical success and microbial eradication were documented in 100% and 91% of 12 cases, respectively. Except one case of fever, no other major adverse effect was observed and no patient required trial therapy discontinuation. In conclusion, our preliminary data seem to suggest a satisfactory activity of teicoplanin against nosocomial gram-positive infections.

Adolescent↗
PubMed1988

Treatment of febrile episodes in neutropenic leukemic patients with the antibiotic combinations piperacillin or ceftazidime plus amikacin: results of a randomized study.

Seventy-six consecutive neutropenic patients with hematologic malignancies, admitted to the "Department of Hematology" of Rome between March and September 1986, were randomly assigned to receive either piperacillin (300 mg/kg in four divided doses) or ceftazidime (100 mg/kg in four divided doses) plus amikacin (15 mg/kg in two divided doses) whenever they developed a febrile episode (temperature greater than 38 degrees C thrice over 12 hours, not related to drugs or transfusions, or else temperature greater than 38.5 degrees C). After 72 hours of antibiotic therapy, in case of persistent fever, piperacillin or ceftazidime was added to the ceftazidime + amikacin or piperacillin + amikacin combination, respectively. The antibiotic treatment was, however, modified according to in vitro susceptibility if a positive culture was present. Success without regimen modification was observed in both antibiotic combinations in 52.6% of cases. Considering the empiric cross of antibiotics, the response rate reached 78%. Neither toxicity nor side effects were observed in the reported groups. Considering blood isolates, we observed a greater incidence of gram-positive organisms compared with gram-negatives (28 cases vs 5 cases, 84.7% vs 15.3% respectively). Fungal infections were documented in four cases, two in each group. Even though no statistical difference was found between the two groups as far as patients not responding to the first antibiotic combination are concerned, piperacillin seems to have had more efficacy (twelve patients responding to the addition of piperacillin vs seven patients responding to the addition of ceftazidime). Piperacillin + amikacin seems to be as effective as ceftazidime + amikacin in the empirical therapy of febrile episodes in neutropenic patients.

Adolescent↗
PubMedDate not supplied

Invasive Fusarium solani infections in patients with acute leukemia.

Two cases of disseminated hyalohyphomycosis due to Fusarium solani in patients with acute nonlymphocytic leukemia were studied. The clinical features in both patients included fever, fungemia, severe myalgias, disseminated ecthyma gangrenosum-like skin lesions, ocular symptoms, and a fatal outcome despite systemic administration of amphotericin B in the setting of profound, persistent granulocytopenia. In vitro studies showed the resistance of both F. solani isolates to amphotericin B, 5-fluorocytosine, and imidazoles. This investigation confirmed the emergence of F. solani infection in immunosuppressed hosts.

Adolescent↗
PubMedDate not supplied

Catheter-related right-sided endocarditis in bone marrow transplant recipients.

Bone marrow transplant recipients are at increased risk of severe central venous catheter-related septicemias that may be complicated by endocardial infection. In view of this, we prospectively evaluated 141 consecutive patients receiving allogeneic or autologous bone marrow infusion. Seven (5%) of 141 patients developed eight episodes of a clinical syndrome compatible with catheter-related right-sided infective endocarditis; this diagnosis was confirmed at autopsy in two patients who died. Staphylococcus epidermidis was the most frequent isolate (four cases). Other offending pathogens were, in one case each, Enterococcus faecalis, Corynebacterium jeikeium, Pseudomonas alcaligenes, and Achromobacter xylosoxidans plus Candida species. Three- to 7-week courses of antibacterial therapy were associated with a favorable outcome in six of the seven cases. Infective endocarditis may be a complication of the use of central venous catheters and should be actively sought in septicemic bone marrow transplant recipients.

Adolescent↗
PubMedDate not supplied

Blastoschizomyces capitatus: an emerging cause of invasive fungal disease in leukemia patients.

Blastoschizomyces capitatus (formerly named Trichosporon capitatum or Geotrichum capitatum) is a rare cause of invasive fungal disease in immunocompromised hosts. We retrospectively studied epidemiologic, clinical, pathologic, and microbiologic features of this infection during a 68-month period at the Division of Hematology of the University La Sapienza in Rome. Twenty patients with evidence of B. capitatus were identified: 12 were infected, four were possibly infected, and four had evidence of B. capitatus colonization but were not infected by this fungus. Pulmonary infiltrates were seen in seven infected patients; four of these patients eventually developed mycetomalike cavitations. Eight infected patients presented clinical and radiologic features of focal hepatitis compatible with hepatosplenic candidiasis. Of the 12 infected patients, two did not receive any antifungal treatment and died, five did not show any response to systemic antifungal therapy, and five received prolonged amphotericin B plus 5-fluorocytosine therapy. Of the last group, three patients achieved stable remission of their acute leukemia and were cured, and two improved but had an apparent relapse of B. capitatus infection after their acute leukemia recurred.

Adolescent↗