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Biomedical subjects

C Brandimarte

Publications and source records attributed to C Brandimarte.

At least 37 records · Page 2Linked to original sources

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↗

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↗

N-formimidoyl-thienamycin and norfloxacin against multiple-resistant Pseudomonas aeruginosa strains. Combined in vitro activity and comparison with 14 other antibiotics.

The in vitro susceptibility of 54 multiple-resistant strains of Pseudomonas aeruginosa to 16 antipseudomonal agents were determined. The majority of these organisms were also beta-lactamase-producing strains. Norfloxacin, N-formimidoyl-thienamycin and aztreonam showed the best antipseudomonal activity, with minimum inhibitory concentrations for 90% of isolates (MIC90) of 2, 8, and 8 mg/l respectively. Of the aminoglycosides, only amikacin (MIC90 = 32 mg/l) showed satisfactory activity, whereas among beta-lactam antibiotics, cefotaxime, ceftriaxone and moxalactam (MIC90 = 32 mg/l) were more active than cefoperazone (MIC90 = 128 mg/l), cefsulodin (MIC90 = 128 mg/l), piperacillin (MIC90 = 512 mg/l) and azlocillin (MIC90 = 1024 mg/l). A synergistic or partially synergistic interaction (fractional inhibitory concentration index less than 1) was demonstrated in vitro against 37% of the strains when N-formimidoyl-thienamycin was combined with norfloxacin.

Amikacin↗

Comparative in vitro activity of aztreonam, other beta-lactam antibiotics and aminoglycosides against Pseudomonas aeruginosa.

Aztreonam, ceftriaxone, moxalactam, cefotaxime, cefsulodin, cefoperazone, piperacillin, azlocillin, carbenicillin, amikacin, gentamicin, tobramycin, sisomicin and dibekacin were tested by broth dilution against 161 isolates of Pseudomonas aeruginosa. Seventy-one of these strains were selected for their resistance to carbenicillin and aminoglycosides and classified as "multiply resistant" strains. Over all, aztreonam showed the greatest antipseudomonal activity by far, followed by ceftriaxone, moxalactam, cefotaxime and amikacin. Piperacillin, azlocillin, cefsulodin, and cefoperazone were highly active against carbenicillin and/or aminoglycoside-susceptible P. aeruginosa strains, but were also poorly inhibitory against multiply resistant isolates.

Aminoglycosides↗

Synergistic treatment of enterococcal endocarditis: in vitro and in vivo studies.

Combinations of penicillin G sodium or ampicillin plus streptomycin sulfate do not produce synergism against all strains of enterococci. This lack of synergism was considered the cause of the failure in the treatment of enterococcal endocarditis. The effect of various combinations of antibiotics on 15 enterococcus strains, which had been isolated from patients with enterococcal endocarditis, was examined. The antibiotics included those that interfere with cell-wall synthesis and those that act on cell metabolism. The in vitro results have shown that while penicillin- or ampicillin-streptomycin combination was not synergistic in eight of 15 strains, penicillin- or ampicillin-gentamicin sulfate combination was synergistic in 100% of the cases. We report seven cases of enterococcal endocarditis that were successfully treated with penicillin- or ampicillin-gentamicin combination, thus confirming the effectiveness of this therapeutic regimen.

Adult↗

The problem of infections in acute leukemias. Personal experience in diagnosis and treatment.

This report is based on experience over the last 5 years in the diagnosis and treatment of infections in 200 acute leukemic patients hospitalized in the Institute of Haematology, University of Rome. The relevant clinical and laboratory findings are discussed in relation to the diagnosis of secondary infections. Most of the febrile episodes were associated with infection. The frequently rapid development of the infections in these patients requires empirical antibiotic treatment. The best results were obtained when the combinations carbenicillin-cephalothin-gentamicin (success rate of 65%), and carbenicillin-cephalothin-gentamicin-lyncomycin-methicillin (success rate of 62%), were used as empirical therapy.

Acute Disease↗