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Biomedical subjects

M Cruciani

Publications and source records attributed to M Cruciani.

At least 73 records · Page 4Linked to original sources
PubMed1987

Cefonicid concentration in lung tissue after intramuscular administration.

A long-acting cephalosporin, cefonicid, was given as a single 1 g dose to sixteen patients hospitalized for lung carcinoma and undergoing thoracic surgery. Lung and serum specimens were obtained approximately 2, 4, 6 and 12 h after injection. Antibiotic assay was made by means of a microbiological method. Effective concentrations of cefonicid in the serum and lung tissue were achieved during the sampling time (12 h). The data suggest that a single dose of cefonicid may be useful for antibiotic prophylaxis in thoracic surgery.

Cefamandole↗
PubMed1987

Penetration of cefonicid in skin suction blister fluid in healthy volunteers.

A new cephalosporin, cefonicid (1 g) was given intramuscularly to six healthy volunteers 12 h after induction of skin suction blister. Serum and blister fluid were collected during a 24 h period. Antibiotic assay was made by a microbiological method. The data were analysed by a one-compartment kinetic model. Despite the high protein binding, cefonicid penetrated in microbiologically effective concentration into blister fluid. Blister fluid concentrations were higher than the serum concentrations at 24 h.

Adult↗
PubMed1986

[Epidemiologic study on the prevalence of Enterobacter, Serratia and Pseudomonas strains, producers of cefoxitin-inducible beta-lactamases].

Resistance of Enterobacter, Serratia and pseudomonas strains to newer cephalosporins is often associated with stable derepression of synthesis of the chromosomal betalactamases. Similar resistance is developed by enzyme inducible strains in response to betalactamases inducers. This finding poses many clinical problems including emergence of resistance during therapy with the drugs. In this study we evaluated the MICs of several new betalactam compounds against 76 Enterobacter, Serratia and Pseudomonas strains before and after cefoxitin-induction of betalactamases. The MICs against several Enterobacter strains (45%) after cefoxitin induction were elevated four fold or more. Serratia strains showed no significant variations of the MICs after cefoxitin induction. The MICs of piperacillin against many Pseudomonas strains (78%) after cefoxitin induction were elevated four fold or more. These data were confirmed using cefoxitin disk approximation test. Outbreaks of nosocominal infection with these multiresistant bacteria and spread of the strains throughout the hospital are already being seen. Control of these problems can only be achieved through the judicious and restricted use of these new antibiotics.

Cefoxitin↗
PubMed1983

Oral prophylaxis with miconazole or ketoconazole of invasive fungal disease in neutropenic cancer patients.

Ketoconazole or miconazole was randomly administered to 42 and 46 neutropenic patients respectively. Of the total number of stool cultures 12% were positive for yeasts in both groups; 4% of the total number of cultures from other sites (nose, throat, skin) were positive in both groups. Candida albicans was the most common isolate, but other fungal species were also identified. No patient developed fungemia; 5/88 patients developed severe oropharyngeal candidiasis while receiving prophylaxis. Among the 21 autopsies performed, 5 cases of pulmonary aspergillosis and 2 local and 1 disseminated candidiasis were demonstrated in 7 patients. Although there was no placebo group of patients in this study, post-mortem data suggest that miconazole or ketoconazole might reduce the incidence of disseminated candidiases in neutropenic patients.

Agranulocytosis↗
PubMed1982

Therapy of Klebsiella pneumoniae septicaemia in neutropenic rats.

The efficacy of intramuscular gentamicin, sisomicin, tobramycin and amikacin was evaluated in the antimicrobial therapy of septicaemia due to Klebsiella pneumoniae in an experimental model of infection in rats rendered neutropenic by cyclophosphamide. Animals were injected with a LD50 of micro-organisms and 4 hours later treated with a therapeutic i.m. dose of the antibiotics. In animals sacrificed at 0.5, 1 and 4 hours after antibiotic treatment, blood levels of aminoglycosides, bactericidal power of serum and quantitative cultures of peritoneal fluid and blood showed that the four antibiotics tested were effective in drastically reducing the number of bacteria in blood and in the peritoneum, concurrently with the bactericidal power of the serum, though with sisomicin preceding in order of activity gentamicin, amikacin and tobramycin.

Agranulocytosis↗
PubMedDate not supplied

Prophylactic co-trimoxazole versus norfloxacin in neutropenic children--perspective randomized study.

Co-trimoxazole or norfloxacin were randomly administered to 44 granulocytopenic children with malignancies in order to prevent bacterial infections. Although more patients in the co-trimoxazole group had febrile episodes (p less than 0.01), the mean of febrile days and the mean of days with systemic antibiotics did not differ significantly in the two groups. Five patients in the co-trimoxazole group had a microbiologically documented infection (four with septicemia) due to Escherichia coli (n = 2), Klebsiella pneumoniae, Pseudomonas aeruginosa, Streptococcus sp. There were four septicemic episodes in the norfloxacin group due to P. aeruginosa, Streptococcus pneumoniae, Streptococcus mitis and Streptococcus faecalis. Compliance was good during administration of both drugs. No signs or symptoms of arthropathy were seen in the norfloxacin group. The number of gram-negative bacilli resistant to co-trimoxazole isolated from stools significantly increased during prophylaxis with co-trimoxazole (p less than 0.001). Norfloxacin did not select resistant strains and was very active in eradicating gram-negative bacilli from stools (27.5% of positive cultures).

Adolescent↗
PubMedDate not supplied

Erythromycin resistance in Streptococcus pyogenes in Italy.

In a prospective study of acute pharyngitis in Italian children, 69 (38.3%) of 180 isolates of Streptococcus pyogenes were resistant to macrolides. S. pyogenes was eradicated in 12 (63.1%) of 19 patients with erythromycin-resistant S. pyogenes treated with clarithromycin and in 22 (88%) of 25 patients with erythromycin-susceptible strains. The constitutive-resistant phenotype was correlated with failure of macrolide treatment.

Adolescent↗
PubMedDate not supplied

Norfloxacin versus cotrimoxazole for infection prophylaxis in granulocytopenic patients with acute leukemia. A prospective randomized study.

Norfloxacin (NOR) or cotrimoxazole (TMP/SMX) were randomly administered to 59 granulocytopenic patients with acute leukemia for prevention of bacterial infections. Nineteen NOR patients (65%) and 22 TMP/SMX patients (73%) complained of febrile or infectious episodes during the study. The mean incidence of febrile complications per patient was higher in the TMP/SMX group: 1.05 vs 0.68 (p less than 0.05). Eleven of 16 microbiologically documented infections in the TMP/SMX group and 7 of 11 in the NOR group were caused by gram negative bacilli (GNB). NOR recipients had fewer days of fever, fewer days on parenteral antibiotics and a lower proportion of time spent febrile. Fecal surveillance cultures showed intestinal GNB colonization in 42/80 specimens in the TMP/SMX group (resistant strains: 93%) and in 8/75 specimens in the NOR group (1 resistant strain). Overall, NOR seems to be effective in eradicating GNB from the digestive tract without selection of resistant strains and in preventing febrile episodes in neutropenic patients.

Acute Disease↗
PubMedDate not supplied

Nosocomial epidemic of active tuberculosis among HIV-infected patients.

In an investigation of a nosocomial outbreak of tuberculosis, 18 HIV-infected inpatients were found to have been exposed to Mycobacterium tuberculosis; active tuberculosis developed in 8, 7 within 60 days of diagnosis of the index case. The patients with lower total lymphocyte and CD4 lymphocyte counts were more likely to get the disease than were those with higher counts. A low score on multiple antigen skin testing was also associated with the development of active tuberculosis. 4 of the 18 patients had a positive tuberculin skin test before exposure to M tuberculosis; none of them subsequently got the disease.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[Antibacterial activity in vitro of several aminoglycosides and cephalosporins].

The "in vitro" rate of killing on different microorganisms was studied for three cephalosporins (cephazolin, cefuroxime and cefoxitin) and four aminoglycosides (gentamicin, tobramycin, sisomicin and amikacin). In all experiments an inoculum effect and a negative influence by adding plasma to the nutrient broth were observed, the latter phenomenon being more pronounced with cephalosporins than with aminoglycosides. While the "in vitro" effects of antibiotic concentrations equal to the MIC or to the MBC were informing on the intrinsic antibacterial activity of single drugs, a more satisfactory approach to therapeutic reality was provided by studying the "in vitro" effects of concentrations equal to peak blood level or to the logarythmic mean of blood level, that is a parameter which contributes to the blood-tissue diffusion gradient. Our data show that antibiotics provided with an higher peak blood level and a more sustained logarythmic mean of blood concentrations, and an higher ratio between these two kinetics parameters and MIC or MBC, are favoured in the experimental system here adopted.

Aminoglycosides↗
PubMedDate not supplied

Mycobacterial diseases and HIV infection.

OBJECTIVES: Evaluation of the incidence of mycobacterial diseases in patients infected with human immunodeficiency virus (HIV) and analysis of survival after diagnosis of mycobacteriosis. METHODS: Retrospective analysis of clinical and laboratory data of HIV-infected patients admitted in our hospital from January 1st, 1985 to March 31st, 1992. RESULTS: We observed 82 infections in 81 patients with an increase in the annual percentage from 2.2% to 6.4%. M. tuberculosis more than atypical Mycobacteria was found in patients with pulmonary infection (p = 0.03). Forty patients had a previous diagnosis of acquired immunodeficiency syndrome (AIDS) and 24 evolved in AIDS because of mycobacterial infection. We observed infection due to M. tuberculosis in patients with advanced HIV-infection (20/27 patients with tuberculosis had CD4+ cell count < 200/cm3). Mean survival after diagnosis and treatment was 329 days with better survival in patients with CD4+ cell count > 200/cm3 (p = 0.03). We did not find a statistically significant difference in survival between patients with tuberculosis and other mycobacteriosis. CONCLUSIONS: Mycobacterial infections are increasing in HIV-infected patients, and tuberculosis is observed also in patients with advanced immunodeficiency. Survival is influenced by the severity of immunodeficiency more than by the mycobacterial species.

AIDS-Related Opportunistic Infections↗