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Biomedical subjects

E Bingen

Publications and source records attributed to E Bingen.

At least 163 records · Page 9Linked to original sources
PubMed1991

Effects of combinations of beta-lactams, daptomycin, gentamicin, and glycopeptides against glycopeptide-resistant enterococci.

Activities of combinations of beta-lactams, daptomycin, gentamicin, teicoplanin, and vancomycin against 11 clinical isolates of Enterococcus faecium highly resistant to glycopeptides, three plasmid-cured derivatives, eight E. faecalis and E. faecium transconjugants, and two susceptible recipient strains were tested. A marked synergy between penicillins or imipenem and glycopeptides against the glycopeptide-resistant strains but not against the glycopeptide-susceptible strains was observed by the double-disk agar diffusion assay. The synergy of combinations of amoxicillin, imipenem, penicillin G, or piperacillin with vancomycin or teicoplanin against resistant strains was confirmed by the checkerboard technique. The fractional inhibitory concentration indexes were generally below 0.25, except for one strain of E. faecium resistant to high levels of penicillin G. However, the combinations were not bactericidal as tested by time-killing experiments, and high concentrations (64 micrograms/ml) of amoxicillin, penicillin G, or piperacillin combined with 8 micrograms of vancomycin or teicoplanin per ml tended to be antagonistic. Addition of 4 micrograms of gentamicin per ml to these combinations enhanced their bactericidal effect, but they occasionally remained slightly less effective than beta-lactams associated with gentamicin. The combination of 10 micrograms of daptomycin per ml with gentamicin was bactericidal after 6 h against 11 glycopeptide-resistant strains.

Anti-Bacterial Agents↗
PubMed1991

[Vancomycin in 1991: current status and perspectives].

Vancomycin is a narrow-spectrum glycopeptide antibiotic which is primarily active against Gram-positive organisms. Bacterial resistance develops rarely due to its numerous modes of action. The mode of action of vancomycin involves the inhibition of peptidoglycan synthesis. Vancomycin forms a stoichiometric complex with the peptidoglycan precursor UDP-N-acetylmuramyl pentapeptide by forming hydrogen bonds. In patients with renal insufficiency vancomycin clearance is reduced and elimination half-life prolonged. Vancomycin is the drug of choice in the treatment of methicillin-resistant staphylococcal infections and in the treatment of Gram-positive endocarditis and has been used as alternative therapy in the treatment or prophylaxis of Gram-positive infections in penicillin-allergic patients.

Cell Division↗
PubMed1990

[Antibiotic therapy of nosocomial infections in children].

The choice of antibiotics for the treatment of hospital-acquired infections in children is a rational choice based on the child's general condition, on the site of infection, on the most probable pathogens and on their current sensitivity to antibiotics. The antibiotic chosen must reach bactericidal concentrations at the site of infection for rapid reduction or the inoculum and to limit the systemic spread of infection, thereby decreasing the risk of a rapidly expanding infectious process in the younger children. The optimal antibiotic is selected on the basis of what is known about bacterial resistance. General therapeutic rules must be adjusted to the epidemiological situation prevailing in each hospital department.

Anti-Bacterial Agents↗
PubMed1990

Bacterial counts in cerebrospinal fluid of children with meningitis.

Eighty-five cerebrospinal fluid (CSF) specimens from the same number of pediatric patients with meningitis were examined to determine the bacterial count and the relationship of this count to the microscopy results, the ages of the patients and the bacterial species isolated. Bacterial counts ranged from 2 x 10 to 4 x 10(9) CFU/ml CSF. Twenty-five percent of the 85 CSF specimens positive for Haemophilus influenzae type b, Neisseria meningitidis, Streptococcus pneumoniae, Escherichia coli K1 and group B streptococci had counts of 10(7) CFU/ml or higher. Children between 1 and 6 months of age had significantly higher counts (p less than 0.05) than the other age groups. The three patients who had positive CSF cultures 24 h after the start of therapy all had initial bacterial counts of 10(7) CFU/ml or higher. The detection limit for Gram stain/microscopy was 10(5) CFU/ml. No correlation was found between bacterial count and the number of polymorphonuclear leukocytes.

Age Factors↗
PubMed1990

Bactericidal activity of vancomycin, daptomycin, ampicillin and aminoglycosides against vancomycin-resistant Enterococcus faecium.

Daptomycin, vancomycin, ampicillin and aminoglycosides, alone or in combination, were tested for their bactericidal activity against 15 isolates of vancomycin-resistant Enterococcus faecium from immunocompromised children. The kill-kinetic studies at clinically achievable concentrations demonstrated that daptomycin alone or in combination with ampicillin had the greatest bactericidal activity.

Aminoglycosides↗
PubMed1989

[Structure-activity relationship of oral cephalosporins].

The advances achieved in the field of oral cephalosporins consist of improved bioavailability and enhanced intrinsic activity of the compounds. Oral absorption is facilitated either by creating prodrugs or by modifying the compound itself with addition of the alpha-amino group at position 7 on the cephem ring or of a vinyl group at position 3. Antibacterial activity and resistance to beta-lactamases are facilitated by the presence of an amino-2-thiazole heterocycle at position 7, associated with a methoxy-imino group or an oxy-imino-acetoxy group.

Absorption↗
PubMed1989

[Current bacteriologic status and therapeutic results in acute otitis media in children aged over 3 months].

355 children, 3 months to 15 years old, presenting with acute otitis media, underwent a bacteriological study of otitis exsudate. From November 1985 to September 1987, 162 myringotomy and 149 acute otitis media spontaneously discharging were studied in Paris. From October 1981 to September 1987, 62 myringotomy and 46 spontaneously discharging acute otitis were studied in Valognes. There was none pathogenic bacterium in respectively 20 and 14% of the samples. Two or more pathogenic bacterium were isolated in 24 and 7% of the samples. In Paris as in Valognes, 3 pathogens were predominants: Haemophilus (17% were beta-lactamase producers), S. pneumoniae and Staphylococcus. There was only 5 and 3% Streptococcus pyogenes, 2% Branhamella catarrhalis in Paris, none in Valognes. Pseudomonas was present only in case of spontaneous otorrhea, even if recent. For the moment, the combination of amoxicillin with clavulanic acid is not our first treatment in case of acute otitis media in children. Actually we prescribe amoxicillin alone, 50 to 100 mg/kg/day. If the child is allergic to beta lactamin, we give him the combination of trimethoprime and sulfamethoxazole.

Acute Disease↗
PubMed1989

[Staphylococcal toxic shock in children].

Toxic shock syndrome (TSS) is reported in 2 children. TSS occurred 10 days after an accidental injury of the fore foot in one case and 5 days following surgery for severe uretero-vesical reflux in the other. The clinical illness was defined by the case definition formulated for epidemiologic studies (CDC, 1982). The diagnosis was confirmed by isolation of a Staphylococcus aureus strain producing TSST, at the infected site. Toxin-induced mediators such as interleukin I and Tumor Necrosis Factor have been incriminated in septic shock with multivisceral involvement. As in our 2 cases, the syndrome may be delayed or even absent.

Adolescent↗
PubMed1988

[Comparison of in vitro activity of 4 oral beta-lactams on microorganisms responsible for broncho-pulmonary infections in children].

MIC 90 and MBC 90 of amoxicillin, cefaclor, cefadroxil and cefuroxime axetil have been determined by the microdilution method against 48 organisms responsible of acute respiratory tract infections in children: 17 E. coli, 15 K. pneumoniae, 16 H. influenzae. An inoculum effect and an inhibitory index in blood and bronchial secretions were determined. An inoculum effect was more important for amoxicillin and cefadroxil than for cefuroxime axetil and cefaclor. Against H. influenzae, cefuroxime axetil and cefaclor have a similar activity. Against Enterobacteria, cefuroxime axetil has the lowest MIC 90 and MBC 90 and the highest inhibitory index.

Administration, Oral↗
PubMed1988

[Choice of first-line antibiotic therapy in the treatment of bone and joint infections in children].

Because of the frequency of Haemophilus influenzae and Staphylococcus aureus in joint and bone sepsis in children, a prospective study of first line antibiotic therapy was performed. In a series of 23 cases, including 8 osteomyelitis and 15 arthritis, Gram stain on joint fluid or antigen detection was helpful in reaching a decision about initial therapy in only 3 cases (Haemophilus influenzae). In 20 of the 23 patients, the first line antibiotic therapy was cefotaxime (100 mg/kg/day) and fosfomycin (100 mg/kg/day) in combination. In 6 of them, the bacteriologic culture was positive (3 Staphylococcus aureus, 1 Haemophilus influenzae and 2 Streptococcus pneumoniae) and the initial antibiotic therapy was changed according to the antibiotic susceptibility testing. In the others 14 cases, from whom no agent was isolated, this combination was continued during about 15 days, then followed by pristinamycin and amoxicillin-clavulanic acid in combination during one month. The C. reactive protein dosage was performed in each patient. All children cured. In view of these first results, cefotaxime and fosfomycin in combination seems to us to be interesting in first line antibiotic treatment without initial orientation.

Adolescent↗
PubMed1988

[Contribution of bactericidal rate in the initial treatment of severe staphylococcal infections in children].

Rapid bactericidal effect is essential for therapy of severe Staphylococcus aureus infections in children. The in vitro activity of clinically achievable levels of vancomycin and its combinations with gentamicin, amikacin and rifampin plus amikacin was studied with the time-kill curve method at 2.5, 4, 6, 24 and 48 hours against 20 strains of Staphylococcus aureus isolated from children with severe staphylococcal infection. Vancomycin alone exerted a bactericidal effect at 48 hours. However, with the combinations vancomycin plus gentamicin, vancomycin plus amikacin and vancomycin plus amikacin plus rifampin a bactericidal effect was respectively observed at 24, 6 and 4 hours. Most rapid killing was achieved with vancomycin plus rifampin plus amikacin. Thus this antibiotic combination seems the most appropriate for initial treatment of severe staphylococcal infections in children.

Anti-Bacterial Agents↗
PubMed1987

[Evaluation of the bactericidal curves of beta-lactam and aminoglycoside combinations at the concentrations obtained in the cerebrospinal fluid in Haemophilus influenzae meningitis].

The prognosis and sequelae of patients with Haemophilus influenzae meningitis were related to concentrations of bacteria in the cerebrospinal fluid (CSF). Rapid bacterial killing and rapid reduction of organisms in vivo in CSF are critical to the outcome. In our patients colony counts of Haemophilus influenzae in CSF were 10(2)/ml - 10(9)/ml (mean 10(5)/ml). Killing kinetics were determined for amoxicillin and cefotaxime, alone and in combination with amikacin, against 35 clinical strains of Haemophilus influenzae (43% beta-lactamase-positive) at concentrations of these antibiotics comparable to those attained in the CSF following systemic administration. Antibiotics concentrations were: amoxicillin: 5 mg/ml, cefotaxime: 3.8 mg/l, amikacin: 1.8 mg/l. Mean killing curves with beta-lactamase-negative strains showed that a bactericidal effect was observed at 18 h for amoxicillin, at 5 h for cefotaxime, at 5 h for amoxicillin plus amikacin and at 2 h 30 for cefotaxime plus amikacin. Against beta-lactamase-positive strains a bactericidal effect was observed at 5 h for cefotaxime, at 2 h 30 for cefotaxime plus amikacin and at 18 h for amoxicillin plus amikacin. The finding of significantly increased killing rates of Haemophilus influenzae by amikacin at low concentration in the presence of either ampicillin or cefotaxime suggests that combined therapy may be beneficial in the treatment of meningitis caused by Haemophilus influenzae.

Amikacin↗
PubMed1987

[Effects of loperamide on the fecal flora in children in severe diarrheas].

Loperamide has been recently indicated in the management of infants with severe protracted diarrhea. The purpose of this study was to determine the effect of loperamide on fecal flora in severe protracted diarrheas. 19 children aged 1 to 36 months, with severe protracted diarrhea were studied: 14 received loperamide (0.5 mg/kg/d) and 5 were without loperamide treatment. Criteria analysed were: clinical tolerance (vomiting and abdominal distention); efficacy (number of stools, transit time and Na+/K+ in stools) and effect on fecal flora, with differential qualitative and quantitative analysis method (complete identification and counts of aerobic and strict anaerobic bacteria in fresh fecal samples before and 4 to 8 days after the beginning of loperamide). Parenteral and/or oral alimentation remain constant during the study. Results show a rapid (24 h) efficacy in 9/14. Although important changes in specific fecal flora counts was noticed for streptococcus D and Proteus as compared to five controls, no bacterial overgrowth appeared or was increased during loperamide treatment.

Child, Preschool↗