Search PubMed⌕ Search

Biomedical subjects

Y Mouton

Publications and source records attributed to Y Mouton.

At least 19 recordsLinked to original sources
PubMed1992

A multicenter study of lomefloxacin and trimethoprim/sulfamethoxazole in the treatment of uncomplicated acute pyelonephritis.

A total of 63 adult patients with uncomplicated acute pyelonephritis were enrolled in a multicenter, randomized comparison of lomefloxacin (400 mg orally once daily for 14 days) and trimethoprim/sulfamethoxazole (TMP/SMX, 160/800 mg orally twice daily for 14 days). Study participants were predominantly female (70% in the lomefloxacin group and 80% in the TMP/SMX group). Escherichia coli was isolated from pretreatment urine cultures in 87.5% of the lomefloxacin group and 80.0% of the TMP/SMX group. Baseline pathogens were eradicated in 100% of evaluable patients in the lomefloxacin group 5-9 days after the end of therapy and in 88.9% of patients in the TMP/SMX group (p = 0.05). The clinical cure rate 5-9 days after therapy with lomefloxacin was 65.0% and for TMP/SMX was 68.4%. At the 4-6 week follow-up in the lomefloxacin group, nine pathogens remained eradicated, one E. coli was isolated, and the results for 14 pathogens were unknown or unevaluable. In the TMP/SMX group, 12 pathogens remained eradicated, three E. coli and one Group D Streptococcus were isolated, and the results for nine pathogens were unknown or unevaluable. Both treatment regimens were well tolerated; adverse events occurred in 12% of patients in the lomefloxacin group and in 17% in the TMP/SMX group. Events considered by the investigators to be probably related to treatment occurred in three patients in each group. In conclusion, once-daily lomefloxacin (400 mg) was a well tolerated and effective alternative to twice-daily TMP/SMX (160/800 mg) for the treatment of adults with uncomplicated acute pyelonephritis.

Acute Disease↗
PubMed1992

Activation-induced death by apoptosis in CD4+ T cells from human immunodeficiency virus-infected asymptomatic individuals.

In immature thymocytes, T cell receptor for antigen (TCR) mobilization leads to an active T cell suicide process, apoptosis, which is involved in the selection of the T cell repertoire. We have proposed that inappropriate induction of such a cell death program in the mature CD4+ T cell population could account for both early qualitative and late quantitative CD4+ T lymphocyte defects of human immunodeficiency virus (HIV)-infected individuals (Ameisen, J.C., and A. Capron. 1991. Immunol. Today. 4:102). Here, we report that the selective failure of CD4+ T cells from 59 clinically asymptomatic HIV-infected individuals to proliferate in vitro to TCR mobilization by major histocompatibility complex class II-dependent superantigens and to pokeweed mitogen (PWM) is due to an active CD4+ T cell death process, with the biochemical and ultrastructural features of apoptosis. Activation-induced cell death occurred only in the CD4+ T cell population from HIV-infected asymptomatic individuals and was not observed in T cells from any of 58 HIV-seronegative controls, including nine patients with other acute or chronic infectious diseases. Activation-induced CD4+ T cell death was prevented by cycloheximide, cyclosporin A, and a CD28 monoclonal antibody (mAb). The CD28 mAb not only prevented apoptosis but also restored T cell proliferation to stimuli, including PWM, superantigens, and the tetanus and influenza recall antigens. These findings may have implications for the understanding of the pathogenesis of acquired immune deficiency syndrome and for the design of specific therapeutic strategies.

Antigens, CD↗
PubMed1992

Broad- versus narrow-spectrum antibiotic use: the role of in vitro testing and its correlation with clinical efficacy.

The spectrum of activity of any antibiotic varies with time, the geographical locale and the site of isolation of the bacteria. This variability is related to the changing heterogeneity (specifically, the degree of resistance) of the bacterial population. In order to choose the most appropriate antimicrobial agent, it is necessary to know the infection site, the degree of diffusion of antibiotics at this site, and the pathogen responsible, and then to determine the sensitivity of the pathogen. If the pathogen is unknown, an assessment of the patient's clinical status should be made; generally, the weaker the patient, the broader the spectrum of antibiotics that should be used. If the pathogen and its in vitro susceptibility pattern are known, narrow-spectrum antibiotics are preferable. The carefully standardized conditions of in vitro testing do not correlate with the in vivo situation, in which the effectiveness of antibiotics is altered by diffusion and immune response. The in vitro tests available do not always correlate with the clinical situation; some bacteria showing resistance in the laboratory are actually susceptible in practice in some infection sites, and vice versa. In vitro tests are also affected by technical limitations. An in vitro test can aid the assessment of efficacy but cannot guarantee it.

Adult↗
PubMed1992

[Value of quinolones in the treatment of lower respiratory tract infections caused by intracellular organisms, excluding mycobacteria].

In vitro studies of quinolones against intracellular pathogens responsible for lower respiratory tract infections have shown that growth inhibition varies with the strain and with the drug. Following administration of quinolones, drug levels in the lower respiratory tract are similar to or greater than serum levels. Quinolones penetrate readily into cells. The effectiveness of quinolones in lower respiratory tract infections has been demonstrated in both in vitro intracellular infection models and in vivo animal models. These data show that quinolones are a valid therapeutic alternative for lower respiratory tract infections due to intracellular organisms.

Anti-Infective Agents↗
PubMed1992

[Varicella in pregnancy after the 20th week of amenorrhea].

We report five cases of varicella pneumonia among ten otherwise healthy pregnant women who were admitted in our hospital between 1986 and 1991 with chickenpox. The precise frequency of this rare complication is not well known actually but analysis of the literature shows that the mortality rate is about 20%. Beside the problem of the fetal varicella syndrome, the other complication is the severe varicella of the neonate which can appear when varicella occurs in the mother within 5 days before, and 2 days after delivery. When primary varicella infection occurs during pregnancy clinical examination must be repeated for a week after occurring of the exanthema to find elements of severity significance. Acyclovir is the drug of choice (10 to 15 mg/kg every 8 hours) for 7 days when pneumonia is present. Varicella-zoster immunoglobulin is useful for prophylaxis and for neonates with high risk of severe varicella.

Acyclovir↗
PubMed1991

Quinolones in the treatment of lower respiratory tract infections caused by intracellular pathogens.

Intracellular pathogens are inhibited to varying degrees, depending upon the strain of the organism and the quinolone tested. Quinolones achieve levels in the lower respiratory tract that equal or exceed serum concentrations, and they also achieve good intracellular concentrations. Experimental models of intracellular infection have demonstrated the efficacy of ciprofloxacin, difloxacin, fleroxacin, ofloxacin and pefloxacin. Animal models of experimental legionellosis have confirmed in vivo their efficacy in this field. Thus, quinolones appear to be a safe and efficacious alternative treatment in lower respiratory tract infection (LRTI) due to intracellular pathogens. Considering the in vitro and experimental studies, quinolones should play an important role in the treatment of LRTI caused by intracellular pathogens, and prospective controlled studies are strongly recommended.

4-Quinolones↗
PubMed1991

[Evaluation of ciprofloxacin versus amoxicillin + clavulanic acid or erythromycin for the empiric treatment of community-acquired pneumonia].

For the empiric management of community-acquired pneumonia, ciprofloxacin (750 mg b.i.d.) was compared with two antibiotics frequently used in this indication, i.e., amoxicillin + clavulanic acid and erythromycin. One hundred and forty-two patients were randomized in this prospective study. Among them, the 63 patients with bacteriologically documented disease were evaluated. Clinical recovery was achieved in 73.3% of patients in the ciprofloxacin group (22/30) versus 81.8% of patients in the amoxicillin + clavulanic acid or erythromycin group (27/33) (non-significant difference). Clinical failures seen with ciprofloxacin were found to be correlated with recovery of Streptococcus pneumoniae. Ciprofloxacin is effective in pneumonia but should be used only in cases where Streptococcus pneumoniae can be excluded as the causative agent.

Adult↗
PubMed1990

[Prospective, randomized, controlled study of imipenem-cilastatin versus cefotaxime-amikacin in the treatment of lower respiratory tract infection and septicemia at intensive care units].

In a multicentre, prospective, controlled trial 211 patients with suspected septicaemia or pneumonia were allocated at random to either imipenem-cilastatin 500 mg 8-hourly or cefotaxime 1 g 6-hourly combined with amikacin 5 mg/kg 8-hourly. The treatments were administered for at least 5 days. Seventy patients on imipenem and 70 patients on cefotaxime-amikacin were assessable for comparison. There were no statistically significant differences between the two groups in underlying pathology and in the clinical results obtained: septicaemia 20/26 patients of the imipenem group and 20/25 patients of the cefotaxime-amikacin group were cured; pneumonia 38/44 patients of the imipenem group and 34/45 patients of the cefotaxime-amikacin group were cured. There were also no differences in the initial organisms and in the bacteriological cure rate, except for Pseudomonas aeruginosa. At the moment, imipenem administered alone is as effective as the cefotaxime-amikacin combination in the treatment of septicaemia or pneumonia in intensive care patients, with the exception of P. aeruginosa pneumonia in patients under assisted ventilation.

Adult↗
PubMed1990

Efficacy of intravenous ofloxacin: a French multicentre trial in 185 patients.

The efficacy of intravenous ofloxacin therapy (200 mg 12-hourly) followed, when appropriate, by oral administration of the same dose was evaluated in an open multicentre trial involving 185 patients in 31 French hospitals. Dosage adjustment was made for patients in renal failure. Infection was hospital-acquired in 35 cases, 53 patients required admission to an intensive care unit. The infections comprised septicaemia (n = 56), pneumonia (n = 18), bronchitis (n = 10), urinary tract (n = 78), female pelvis (n = 8), bone and joint (n = 5), skin and soft tissues (n = 10). The causative pathogens were: Staphylococcus spp. (n = 23), Streptococcus spp. (n = 11), Escherichia coli (n = 85), Haemophilus influenzae (n = 9), Klebsiella, Enterobacter or Serratia spp. (n = 21), Salmonella spp. (n = 22), Chlamydia spp. (n = 3), Legionella spp. (n = 1), Mycoplasma pneumoniae (n = 1) and miscellaneous Gram-negative bacilli (n = 17). All were ofloxacin-susceptible. Mean duration of therapy was 8.06 ( +/- 2.6) days for the i.v. and 14.8 ( +/- 14.39) days for the oral preparation. Clinical cure was achieved in 173 patients (93.5%). It is concluded that iv ofloxacin is an effective treatment for a range of infections due to susceptible organisms.

Administration, Oral↗
PubMed1990

[Cardiac hydatidosis: contribution of magnetic resonance imaging. Report of a case].

Cardiac hydatid cyst is a rare condition. The diagnosis is difficult and is based on a series of findings amongst which hydatid serology and cardiac imaging play important parts. The values and limitations of echocardiography, coronary angiography and CT scanning are well known. Nuclear magnetic resonance imaging is a recent technique which theoretically should provide valuable diagnostic information. The authors report a case in which this technology, though confirming the presence of a polycystic intrapericardial mass, did not show the true extension of the disease.

Adult↗
PubMed1990

[Acyclovir and specific anti-varicella-herpes zoster immunoglobulins in the treatment of varicella-zoster virus infection in 113 adults].

From January 1978 to December 1988, 54 males and 59 females were treated for varicella, zoster and disseminated zoster by varicella-zoster immunoglobulin (group I) or acyclovir (group II). 67 patients had immune deficiency disease. Treatment was successful for 92/100 patients in group I and for 100/100 patients in group II. Thrombophlebitis and renal failure were observed in group II and regressed when acyclovir was stopped. Varicella-zoster immunoglobulin and acyclovir are two effective therapeutics in the treatment of varicella and zoster in adults including immunocompromised patients. The use of acyclovir could not reduce the duration of hospitalization.

Acyclovir↗
PubMed1989

[Nosocomial pneumopathies].

The criterion used for the diagnosis of nosocomial pneumonia is an infiltrate on X-ray of the chest, not present on admission, associated with new sputum production. The main causative pathogens are Staphylococcus spp. and Gram-negative bacilli. The most common pattern in the development of pneumonia is colonization of the oropharynx followed by aspiration into the lungs in patients with impaired normal defences. The factors which significantly predispose to nosocomial pneumonia are tracheal intubation, low level of consciousness, chronic lung disease, thoracic or upper abdominal surgery, large volume aspiration and age over 70 years. The fatality rate is high (32 p. 100 to 55 p. 100). In most cases the curative treatment requires a combination of antimicrobial agents. At the moment, preventive measures remain an elusive goal.

Cross Infection↗
PubMed1989

[Can nosocomial infections be prevented?].

Nosocomial infections constitute an important problem in terms of morbidity, wHich can be measured as excess hospital stay, mortality and extra-cost. A third of these infections can be prevented by an effective control programme, as shown by the results of the SENIC Project, but this requires a close co-operation between infection control nurses, physicians interested in infection control and practising epidemiological supervision and hospital personnel. Data concerning the four main sites of nosocomial infections (surgical wounds, urinary tract, lower respiratory tract and bloodstream) are reviewed, and the main guidelines regarding their prevention are summarized.

Cross Infection↗