Search PubMed⌕ Search

Biomedical subjects

M L Corrado

Publications and source records attributed to M L Corrado.

At least 37 records · Page 2Linked to original sources
PubMed1987

Use of norfloxacin in the treatment of acute diarrheal disease.

In studies conducted in seven countries, 392 persons with acute diarrhea were enrolled and randomly assigned to one of three regimens. In order to compare the effectiveness of various therapies for acute gastroenteritis, patients were treated for five days with either norfloxacin, 400 mg twice daily, norfloxacin, 400 mg three times a day, or trimethoprim/sulfamethoxazole, (160 mg/800 mg) twice daily. Clinical cure occurred in 89 percent (lower dose) and 91 percent (higher dose) of those treated with norfloxacin, compared with 78 percent of those receiving trimethoprim/sulfamethoxazole; cure rates in each treatment group were greater when the patient's stool contained fecal leukocytes. In 105 of 106 (99 percent) patients treated with either dose of norfloxacin and in 49 of 52 (94 percent) trimethoprim/sulfamethoxazole-treated subjects, the bacterial enteropathogen identified in the pretreatment stool was eradicated on the posttreatment specimen. Two percent (two patients) of those receiving the lower dose of norfloxacin, 3 percent (two patients) of those receiving trimethoprim/sulfamethoxazole, and 4 percent (three patients) of those receiving the higher dose of norfloxacin experienced minor and transient adverse hematologic or blood chemistry reactions. In addition, mild cutaneous reactions that were attributed to the study medications developed in two patients receiving the higher dose of norfloxacin and in three patients who received trimethoprim/sulfamethoxazole. These studies indicate that norfloxacin is safe and effective therapy for bacterial diarrhea.

Acute Disease↗
PubMed1987

Effect of inoculum size on in vitro activity of norfloxacin against fecal anaerobic bacteria. Rationale for selective decontamination of the digestive tract.

Previous studies have shown that anaerobic bacteria are susceptible to norfloxacin at the levels attained in the feces. Conversely, studies in laboratory animals and neutropenic humans using norfloxacin for selective decontamination of the digestive tract have shown that norfloxacin markedly reduces the aerobic enteric flora without reducing fecal anaerobic flora. In an effort to resolve this paradox, the effect of a 10(9) colony-forming units (cfu)/ml inoculum, which is more reflective of actual fecal counts than the standard 10(5) cfu/ml inoculum, on the activity of norfloxacin against two fecal Escherichia coli isolates and 16 fecal anaerobic isolates was studied. The results showed a marked inoculum effect at 10(9) cfu/ml for most anaerobic isolates but not for the E. coli strains tested. At 256 micrograms/ml, all E. coli were killed while the anaerobic bacteria maintained colony counts greater than or equal to 10(9) cfu/ml. Hence, the lack of anaerobic activity (minimal inhibitory concentration greater than or equal to 512 micrograms/ml) at higher fecal inocula might explain the utility of norfloxacin in selective decontamination of the bowel.

Adult↗
PubMed1987

Compassionate use of norfloxacin.

Norfloxacin, a new oral fluoroquinolone, has a spectrum of activity and pharmacology that suggest it may be useful in certain infections in which other agents are inactive or have anticipated toxicity. This report is an analysis of 61 "compassionate" requests for norfloxacin that resulted in 42 treatment courses. The reasons for use included multiresistant pathogens susceptible only to norfloxacin in 42 percent, failure of prior use of a marketed antibiotic in 34 percent, and preferred use of norfloxacin due to anticipated toxicity from an aminoglycoside in 32 percent or from other agents in 9 percent. Infections treated included 29 complicated urinary tract infections, 23 involving multiresistant Pseudomonas species, and 10 gastrointestinal infections, seven involving Salmonella species. Prophylaxis of infection was initiated in three neutropenic patients with leukemia. The duration of norfloxacin therapy ranged from eight to 28 days at a daily dose of 800 mg (400 mg twice daily). Norfloxacin treatment resulted in clinical cure or improvement in 84 percent of patients and eradicated the etiologic pathogen(s) 52 percent of the time. In Pseudomonas species infections, cure was achieved in 29 percent of patients and 57 percent showed improvement; the pathogen was eradicated in 43 percent of these infections. Resistance developed in four of the eight Pseudomonas species infections that persisted. Based on a review of compassionate therapy cases, it appears that norfloxacin is effective oral therapy for many complicated urinary and gastrointestinal infections for which other agents cannot be used because of bacterial resistance or anticipated toxicity.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Safety and efficacy of imipenem/cilastatin in treatment of complicated urinary tract infections.

Forty-three patients were treated with imipenem/cilastatin for urinary tract infections. The patients were predominantly men (77 percent), 60 years of age or older (81 percent), and had infections caused by Pseudomonas aeruginosa (58 percent). Forty of 43 cases were complicated (including tumor, stone, obstruction, and renal insufficiency). Approximately 33 percent of patients were febrile (temperature greater than 100.4 degrees). All patients received 500 mg of imipenem/cilastatin intravenously every eight hours. Microbiologic eradication was defined as a sterile urine culture sample obtained from two consecutive urine cultures, one during therapy and one five to nine days after therapy. All patients experienced clinical improvement with microbiologic eradication. No patients experienced drug-related clinical adverse effects.

Adult↗
PubMed1983

The comparative activity of norfloxacin with other antimicrobial agents against Gram-positive and Gram-negative bacteria.

Norfloxacin (MK0366) displayed appreciable activity against the great majority of Gram-negative and Gram-positive bacteria. The minimum inhibitory concentration for 90% of isolates (MIC90) of the Enterobacteriaceae was 0.5 mg/l or less while for Campylobacter, Neisseria, Haemophilus MIC90s were 0.25 mg/l or less. Norfloxacin was also among the most active drugs tested against methicillin susceptible and resistant Staphylococcus aureus, Staph. epidermidis, enterococci and Pseudomonas aeruginosa with MIC90s between 0.5 and 4 mg/l.

Anti-Bacterial Agents↗
PubMed1983

Pulmonary cryptococcosis and Cushing's syndrome.

Pulmonary cryptococcosis occurred in two patients with Cushing's syndrome, both of whom were successfully treated with amphotericin B and flucytosine. Excessive endogenous production of corticosteroids may have predisposed these patients to the development of opportunistic infection. Persons with Cushing's syndrome and a pulmonary infiltrate should be examined for infection with Cryptococcus neoformans in addition to an examination for ectopic adrenocorticotropic hormone production.

Adult↗
PubMed1982

Designing appropriate therapy in the treatment of gram-negative bacillary meningitis.

Gram-negative bacillary meningitis is being diagnosed more frequently, and the introduction of newer beta-lactam antibiotics has contributed significantly to successful therapy. These new agents--became of their ease of administration and relative safety--also allow nonspecialists to treat the disease. There are, however, pitfalls in therapy of infections due to this heterogenous group of organisms. Extremely susceptible organisms, such as Escherichia coli and Klebsiella pneumoniae, most often respond to cephalosporin monotherapy, whereas relatively resistant organisms such as Acinetobacter and some Enterobacter may not. In these cases, combination therapy with an aminoglycoside is warranted. Testing the infecting organism for antibiotic susceptibility at the appropriate inoculum and pH may be useful in predicting therapeutic outcome.

Adult↗
PubMed1982

Chronic mycotic meningitis with spinal involvement (arachnoiditis): a report of five cases.

Five patients developed mycotic spinal arachnoiditis-meningitis causing signs and symptoms of spinal cord neoplasm. Four had cryptococcal infection, the fifth had aspergillosis. In three patients, diagnosis was made at surgery; all three developed acute fungal meningitis postoperatively and two died. The diagnosis was made nonsurgically in two patients and was followed by medical cure. These five and twelve other reported patients with mycotic spinal arachnoiditis shared features that suggested the diagnosis. In contrast to most patients with spinal tumors, those reported here tended to be young (mean age, 32 years), to lack evidence for a primary tumor, and to have a fluctuating history of spinal symptoms for several months. Frequent associated findings were recent pregnancy; the abuse of alcohol, narcotics, or both; and the presence of headache and fever. Plain roentgenograms of the spine were normal. No single finding was diagnostic, but the combination of several would be rare with spinal tumor.

Adult↗
PubMed1982

Susceptibility of dermatiaceous fungi to amphotericin B, miconazole, ketoconazole, flucytosine and rifampin alone and in combination.

The dematiaceous fungi comprise a group of organisms that are deeply pigmented and found in soil or on decaying organic material, such as wood. The majority of infections with these fungi presumably results from traumatic inoculation. Although various forms of infection have been appreciated for some time, none of the presently available antifungal drugs have been shown to have predictable activity against these organisms. We report on the activity in vitro of various antifungal agents alone and in combination against various dematiaceous fungi.

Amphotericin B↗
PubMed1982

Gram-negative bacillary meningitis. New therapy and changing concepts.

Because the CSF is deficient in opsonic and phagocytic activity, optimal therapy for meningitis mandates the use of antibiotics that are bactericidal at achievable CSF concentrations. This therapeutic principles is satisfied for the common meningeal pathogens (Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis) but is not readily achieved for the pathogens causing Gram-negative bacillary meningitis (GNBM), such as Klebsiella and Escherichia coli. The antibiotics used to treat GNBM, chloramphenicol and aminoglycosides, are not bactericidal against enteric pathogens at achievable CSF levels. Two new beta-lactam antibiotics, moxalactam disodium and cefotaxime sodium, are suitable agents for the treatment of GNBM. These antibiotics possess potent bactericidal activity against most enteric pathogens and achieve high levels in the CSF (15 to 35 micrograms/mL for moxalactam disodium and 2 to 10 micrograms/mL for cefotaxime sodium). Recent clinical studies document an 85% cure rate when these agents are used to treat GNBM.

Aminoglycosides↗
PubMed1981

Past and current roles for cephalosporin antibiotics in treatment of meningitis. Emphasis on use in gram-negative bacillary meningitis.

The therapy of gram-negative bacillary meningitis is less than adequate to date; the agents recommended do not achieve bactericidal levels in purulent cerebrospinal fluid. Because optimal antibiotic therapy of meningitis occurs when the cerebrospinal fluid level of an antibiotic is above the concentration needed to kill the offending pathogen, another group of agents needs to be considered. The newer cephalosporins or cehalosporin-type antibiotics (cefotaxime, moxalactam), by virtue of their marked activity against gram-negative bacilli and their ability to achieve significant CSF levels, merit serious consideration as therapy for gram-negative bacillary meningitis. Investigators in Europe and the United States have developed preliminary data demonstrating the efficacy of these agents in a growing number of cases. In the group presented herein, of the 35 cases in which gram-negative bacillary meningitis was treated with the newer cephalosporins, there were only four failures.

Adolescent↗
PubMed1981

Infections caused by Actinomyces viscosus.

Two cases of Actinomyces viscosus infection of the lungs were seen in nonimmunosuppressed patients. One patient had a peripheral actinomycotic lung mass resembling a tumor. Both patients responded to a long course of penicillin therapy. Reports of A. viscosus infections are rare, although the organism colonizes the mouths of most adult humans. Only ten cases have previously been described. There is no characteristic of A. viscosus infection that can distinguish it from Actinomyces israelii or Actinomyces bovis infections. The illness usually manifests as a chronic disease weeks to months before the diagnosis, which can only be made by identification of the organism from a clinical specimen uncontaminated by sputum or mouth flora. Ignorance of the biochemical reactions and growth characteristics of this organism have in the past hindered its isolation and identification. At least three weeks of antibiotic therapy using agents to which A. viscosus is sensitive in vitro are required for cure.

Actinomyces↗
PubMed1981

Activity of moxalactam and cefotaxime alone and in combination with ampicillin or penicillin against group B streptococci.

The activities of moxalactam and cefotaxime, alone and combined with ampicillin or penicillin, against 40 isolates of group B streptococci were assessed by using the microtiter broth dilution, checkerboard, and time-kill techniques. Penicillin and cefotaxime were bactericidal for all isolates at concentrations of 0.06 micrograms/ml or less. Ampicillin was slightly less active. Moxalactam was bactericidal for all strains at concentrations of 4 to 8 micrograms/ml. The ampicillin- moxalactam combination was partially synergistic for 60% of the isolates tested; the ampicillin-cefotaxime combination was partially synergistic for 35% of these isolates. No instances of antagonism were observed. In time-kill evaluations, ampicillin (3.0 micrograms/ml) and penicillin (0.75 micrograms/ml) effected 2.5 to 3.5 log10 reductions in numbers of colony-forming units. The addition of 4 micrograms of cefotaxime per ml or 8 to 16 micrograms of moxalactam per ml to penicillin or ampicillin did not alter killing kinetics. Moxalactam and cefotaxime neither enhanced nor decreased the activity of ampicillin or penicillin against group B streptococci.

Ampicillin↗
PubMed1981

Susceptibility of gram-positive cocci to various antibiotics, including cefotaxime, moxalactam, and N-formimidoyl thienamycin.

The activities of cefotaxime, moxalactam, MK 0787 (N-formimidoyl thienamycin), ampicillin, oxacillin, vancomycin, and clindamycin were compared against gram-positive cocci. MK 0787 was the most active and moxalactam was the least active of these drugs, except against methicillin-resistant Staphylococcus aureus, where vancomycin was most active, and penicillin-resistant pneumococci, where cefotaxime was more active.

Ampicillin↗