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Biomedical subjects

M Cruciani

Publications and source records attributed to M Cruciani.

At least 55 records · Page 3Linked to original sources
PubMed1991

Comparative efficacy of ceftriaxone versus ceftazidime in the treatment of nosocomial lower respiratory tract infections.

Seventy-two hospitalized patients with pneumonia or bacteremia were randomly allocated to receive ceftriaxone 2 g once daily i.v. or ceftazidime 2 g twice a day i.v. At the end of the study 60 patients were evaluable, 31 in the ceftazidime group and 29 in the ceftriaxone group. Thirty-four patients (ceftazidime = 15, ceftriaxone = 19) yielded one or more pathogens, of which 64% were gram-negative bacilli. Clinical cure or improvement was observed in 90% of patients in both groups. All 3 cases of bacteremia were cured. Three patients in each group failed to respond to the administered drug. Eradication of the pathogen(s) was observed in 82% of the ceftazidime group and in 86% of the ceftriaxone group. Two episodes of superinfection due to Pseudomonas aeruginosa were recorded in the ceftriaxone group, while Candida spp. was isolated from the sputum in 2 patients in the ceftazidime group. Three strains of P. aeruginosa (2 in the ceftazidime group, 1 in the ceftriaxone group) persisted despite the treatment. No side effects were seen except for skin rash in 2 patients receiving ceftazidime. Compliance was good in both groups, particularly with the once daily administration of ceftriaxone. Overall ceftriaxone and ceftazidime appear to be equally effective in the treatment of nosocomial pneumonia, with the exception of P. aeruginosa infection.

Adolescent↗
PubMed1990

Treatment of bone and soft tissue infections with teicoplanin.

The use of teicoplanin was evaluated in a group of 33 patients, which included 18 prosthetic infections, seven with osteomyelitis, five skin and soft tissue infections, and three cases of septic arthritis. The bacterial pathogens isolated were 27 isolates of Staphylococcus aureus (methicillin sensitive 18; methicillin resistant 9), Staph. hominis (2), Staph. epidermidis (1), Staph. haemolyticus (2), Enterococcus faecalis (1), Streptococcus pyogenes (1), Peptococcus spp. (1). Eleven patients had polymicrobial infections (Gram-positive plus Gram-negative and/or anaerobic bacteria). In ten cases (nine polymicrobial infections) teicoplanin was used in combination with other antibiotics. Teicoplanin was administered intravenously 400 mg every 24 h in 26 cases, 200 mg every 24 h in six cases and 600 mg every 24 h in one case. The duration of the treatment ranged from 9 to 73 days with a mean of 27.3. Efficacy was evaluable in 30 patients, because in three patients treatment was stopped because of adverse reactions. Cure or improvement was noted in 28 patients (93%). Bacteriological cure occurred in 25 patients (83.3%).

Adolescent↗
PubMed1990

In vitro antibacterial activity of cefotaxime and desacetylcefotaxime, alone or in combination, against gram-positive cocci.

The in vitro activity of cefotaxime and desacetylcefotaxime against Staphylococcus aureus, Staph. epidermidis and Streptococcus pyogenes was investigated. Synergy studies were performed using time-kill curves and the chequerboard test. The time-kill curves were performed on five strains each of Staph. aureus, Staph. epidermidis and Strep. pyogenes; cefotaxime and desacetylcefotaxime were tested alone or in combination at MIC and sub-MIC values. The chequerboard test was performed in microtitre plates on ten strains each of Staph. aureus, Staph. epidermidis and Strep. pyogenes: the results were interpreted by the fractional inhibitory concentration index. In some cases both methods showed synergistic interaction against the staphylococci tested. Indifference was observed against Strep. pyogenes.

Cefotaxime↗
PubMed1990

Teicoplanin therapy in children: a review.

Teicoplanin has been investigated mainly in adults and to a lesser extent in children. Pharmacological studies in children aged 2-12 years showed that a daily dose of 3-6 mg/kg of teicoplanin was insufficient to maintain microbiologically effective trough serum levels, while a regimen of 10 mg/kg/day was sufficient to obtain effective serum concentrations. Teicoplanin has been administered, alone or in combination therapy, to neutropenic or non-neutropenic paediatric patients. Combinations of teicoplanin (10 mg/kg/day) plus beta-lactams or aminoglycosides have been found effective in the treatment of febrile episodes in neutropenic (less than 500 pmn/microliters) children. Teicoplanin, 3-10 mg/kg i.v., has been administered as the sole antibiotic agent as a daily dose to more than 100 children and newborns with documented or suspected Gram-positive infections. Overall, teicoplanin was found to be a very effective and well tolerated treatment for Gram-positive infections in pediatric patients. Further trials are required to confirm these observations.

Bacterial Infections↗
PubMed1990

AIDS--associated predominantly sensory neuropathy. The role of herpes viruses.

Three patients with predominantly sensory neuropathy in course of HIV-1 infection are reported. In all cases ultrastructural examination showed herpes virus-like particles in the axoplasmic matrix of myelinated fibers and in endoneurial macrophages. In 2 cases clinical patterns of posterior column involvement were observed.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[A clinical study on the use of norfloxacin in the therapy of urethritis caused by Chlamydia trachomatis].

Norfloxacin (NOR) was given to 37 patients affected by urethritis due to Chlamydia trachomatis (CT), as demonstrated by clinical findings and fluorescent monoclonal antibody in urethral swab. The patients were divided into two groups according to a randomization list, and given either: NOR 400 mg t.i.d. or NOR 800 mg b.i.d. for 10 days. The 2 groups were comparable in terms of age, clinical presentation and duration of symptoms. Six out of 18 patients treated by regimen 2 had persistence of CT at the end of treatment (2 cases were clinically improved), while 4 out of 19 patients in group 1 dit not respond to the treatment. Overall 12 patients in group 2 (66.6%) and 15 patients in group 1 (79%) were asymptomatic and negative for fluorescent antibody at the end of the treatment. Both regimens were well tolerated. Our data show that NOR given at dosage higher than those usually recommended (e.g. 400 mg b.i.d.), may be of value for the treatment of urethritis due to Chlamydia trachomatis.

Adolescent↗
PubMed1989

Teicoplanin in the treatment of infections by staphylococci, Clostridium difficile and other gram-positive bacteria.

Eighty-three episodes of Gram-positive infection in 82 patients were treated with teicoplanin in an open study. Infectious episodes included endocarditis (6 cases), bacteraemia (7), osteomyelitis (8), pseudomembranous colitis (13), cellulitis (11), urinary tract infection (5), pneumonia (1), wound and post-surgical infections (9) and erysipelas (23). Four patients affected by an overwhelming Gram-positive infection as well as eight cases of Gram-positive-Gram-negative mixed infections received teicoplanin in combination with other antibiotics. The average duration of treatment was 16 days (range 5-70). In pseudomembranous colitis teicoplanin was given by mouth for ten days. Staphylococcus aureus (11 methicillin-sensitive and 13 methicillin-resistant strains) and Clostridium difficile (13 isolates) were the most frequent pathogens. Overall 89% (74/83) of the infections were cured, 3.6% (3/83) improved and 3.6% (3/83) failed. Relapse and superinfection were observed in 2.4% (2/83) and 1.2% (1/83) episodes respectively. All pseudomembranous colitis cases were clinically cured and C. difficile was eradicated in all but one patient. The MIC range, MIC50 and MIC90 (mg/l) of teicoplanin for C. difficile were less than 0.125-0.250, less than 0.125 and 0.250 respectively. Pharmacokinetic studies in patients given a single iv daily maintenance dose of 400 mg showed that the steady-state trough teicoplanin concentrations in serum were reached on day 8. Assays of skin-subcutaneous tissue biopsies showed that teicoplanin penetrated well into these structures. Side effects were observed in six of the 82 treated patients (7.3%) and teicoplanin had to be discontinued in four cases. The results of the study show that teicoplanin is a safe and useful new agent for the treatment of infections caused by Gram-positive organisms, including methicillin-resistant staphylococci and C. difficile.

Adolescent↗
PubMed1988

Antibacterial activity after a single-dose of norfloxacin, ofloxacin and pipemidic acid detected in urine of volunteers.

Six healthy volunteers received in a triple-crossover design a single oral dose of norfloxacin, ofloxacin or pipemidic acid. Urine samples were collected during the 24 h following the administration and were tested for inhibitory and bactericidal activity against selected strains of Enterobacteriaceae and Pseudomonas aeruginosa. Norfloxacin and ofloxacin inhibited the urinary growth of sensitive strains during the 24 h of sampling time at dilutions much higher than those generally considered satisfactory. Nalidixic acid was less effective and did not achieve bactericidal activity against Ps. aeruginosa over the interval of 12 to 24 h.

Adult↗
PubMed1988

Serum bactericidal activity against aerobes and anaerobes of volunteers receiving cefoxitin or cefotetan.

Six volunteers received intravenously a single 1 g dose of cefoxitin or cefotetan. The 2 groups were crossed after a week of washout. Five strains each of Escherichia coli, Klebsiella pneumoniae, Bacteroides fragilis and Bacteroides thetaiotaomicron susceptible to the administered drugs were tested for serum bactericidal activity (SBA). Blood samples were obtained before and 0.5, 3.0 and 12.0 hours after antibiotic injection. SBA was determined using microtitre procedures. Anaerobic bacteria were incubated in an anaerobic chamber. Cefotetan showed a very high SBA both against aerobes and anaerobes over the 12 hour sampling time. Cefoxitin reached satisfactory SBA values only 0.5 hours after administration.

Adult↗
PubMed1987

Antistaphylococcal activity of teicoplanin in association with other antibiotics.

The in vitro activity of antibiotic combination of teicoplanin and gentamicin (or netilmicin) and teicoplanin and cephalotin on Staphylococcus aureus was evaluated using the checkerboard method and time-kill curves. With few exceptions neither antagonism nor synergism was seen for the combination of teicoplanin and aminoglycosides using the checkerboard method. Using time-kill curves synergism was often found for the combination of teicoplanin and netilmicin (even at sub-minimal inhibitory concentrations of netilmicin) and for the combination of teicoplanin and cephalotin. No antagonistic interactions occurred.

Anti-Bacterial Agents↗
PubMed1987

Teicoplanin in the therapy of staphylococcal neuroshunt infections.

Three patients with staphylococcal infection of neuroshunt, two with ventriculoperitoneal and one with external ventricular derivation, were treated with teicoplanin given intravenously (iv) or intraventricularly (ivt), two patients were adults, while the third was an infant. The causative organisms were methicillin-sensitive Staphylococcus epidermidis (MSSE) in the first two cases and methicillin-sensitive Staphylococcus aureus (MSSA) in the paediatric patient. Patient No. 1 was given teicoplanin iv (400 mg/day) and subsequently ivt (20 mg/day). CSF teicoplanin levels were always below 1 microgram/ml during the first part of the treatment; after the institution of ivt therapy, drug levels ranged from 20 to 35 micrograms/ml (mean 26.4). The patient was cured after 20 days of a combination treatment (ivt teicoplanin plus rifampin, 900 mg/day, iv). Patient No. 2 was given teicoplanin 400 mg/day, iv, for two weeks; its low levels in CSF (always below 0.5 microgram/ml) accounted for the failure to eradicate the MSSE. A new regimen with teicoplanin, 20 mg/day plus netilmycin, 15 mg/day, both ivt, cured the patient in two weeks. Teicoplanin levels in the CSF ranged from 12.5 to 33 micrograms/ml (mean 18.3). Patient No. 3, an 8-month-old infant, was placed on teicoplanin, 5 mg/day ivt plus chloramphenicol, 180 mg/day iv, after several other antibiotic trials had failed to eradicated a MSSA infection of his external ventricular derivation. The therapy cleared the infection in one week (CSF teicoplanin levels: 30 to 38, mean 34 micrograms/ml). Teicoplanin (iv or ivt) was well tolerated without any significant side-effects; its role in the treatment of staphylococcal neuroshunt infections deserves further studies.

Adolescent↗