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PubMed1990

Antibiotic therapy for common infections.

Several important points regarding the treatment of urinary tract infections should be made. Single-dose and short-course antibiotic therapy is appropriate only for women with acute bacterial cystitis due to E. coli. Studies comparing single-dose to full-course therapy have not been sufficiently designed to draw valid statistical conclusions, and only TMP/SMX is recommended at this time. Recurrent UTI in women is almost always due to reinfection, which is best managed by prophylactic antibiotics. Acute bronchitis and acute exacerbations of chronic bronchitis are often due to viral infections, and therefore antibiotic therapy is not always needed. In acute exacerbations of chronic bronchitis, the clearest success rates for antibiotic therapy have been in patients, who have all three of the following symptoms: increased dyspnea, increased sputum production, and sputum purulence. Mupirocin is an important addition to the agents used to treat bacterial skin infections due to streptococcal and staphylococcal strains. In impetigo, mupirocin has been demonstrated to be as effective or superior to oral erythromycin. In prostatitis, data on the fluoroquinolones appears impressive, but further comparative trials are needed. They may become first-line, empiric therapy. The newer oral antibiotics are not recommended as initial, empiric therapy in the outpatient management of common infections, with the possible exception of the treatment of prostatitis. These newer agents may be more important in the treatment of recurrent or resistant infections.

Anti-Bacterial Agents↗
PubMed1990

[Laboratory and clinical studies on cefdinir in pediatric field].

Clinical trials of cefdinir (CFDN) in pediatric infections were carried out. Results are summarized as follows. 1. Mean half-lives of CFDN in serum in children when administered on an empty stomach were 1.24 hours (3 mg/kg per os) and 1.85 hours (6 mg/kg per os). 2. Mean 8 hour urinary excretion rates of CFDN were 19.0% (3 mg/kg/per os) and 10.5% (6 mg/kg per os). 3. CFDN was administered to 28 children with various infections: 12 patients with tonsillitis, 8 with bronchitis, 2 with pneumonia, 4 with urinary tract infections, 1 staphylococcal scalded skin syndrome and 1 with impetigo. The overall efficacy rate was 89.3%. 4. Diarrhea was noted in 1 patient. Abnormal laboratory test values encountered were eosinophilia in 2 patients, thrombocytosis in 1.

Adolescent↗
PubMed1990

The role of microorganisms in atopic dermatitis.

The course of atopic dermatitis is widely determined by environmental factors such as physical or psychogenic stress and reactions to allergens or microorganisms. The latter include bacteria, viruses and fungi, especially Staphylococcus auerus, Herpes simplex virus (HSV), and Pityrosporum orbiculare. In childhood, Impetigo around the big joints is frequently seen, while the characteristic reaction to S. auerus in the young adults is pruritic pustules on the extremities or an exacerbation of the eczema to an exudative dermatitis. Similarily, P. orbiculare may induce a flare-up of the eczema of the head and neck, while HSV may cause a true wide-spread infection known as eczema herpeticum. An immunological disorder, a fragile skin, and special properties of the microorganism may account for the altered response to infection or severe colonization in the patient with atopic eczema. During exacerbations of the eczema, supplementary treatment with proper antimicrobial agents has been shown to be of great value.

Bacterial Physiological Phenomena↗
PubMed1990

Infectious skin diseases.

Descriptions of individual diseases, including impetigo, scarlet fever, and toxic shock syndrome, are presented in the context of the specific organisms that cause them. Pictures are used to show some of the diseases. Testing and treatment information for these diseases are included.

Anti-Bacterial Agents↗
PubMed1990

[Epidemiology of communicable skin diseases in school children of a rural area in North Ethiopia].

The pupils of 5 elementary schools in the Dembia-District in Northethiopia were inspected in serial examinations. The transmissible skin diseases head lice infestation, tinea capitis, impetigo contagiosa and verrucae vulgares are very common among the unselected children (5 to 15 years old). Only 16% of all children had not any infectious skin disease. The investigations showed the unfortunate conditions of the poor hygiene those are existing in the rural areas of a developing country in the tropics.

Adolescent↗
PubMedDate not supplied

[Probable ADH inappropriate secretion syndrome in varicella].

Varicella (chickenpox) is sometimes associated with serious complications characterized bp changeable frequency in different ages. We describe a case of varicella with contemporary presence of several complications: serious impetigo , conjunctivitis, pneumonia, hepato-encephalic disease (probable Reye syndrome). This case is interesting because after adequate rehydration and normalization of electrolytes we registered a remarkable fall of plasmatic sodium and chloride as a result of hemodilution probably due to a syndrome of inappropriate secretion of antidiuretic hormone, confirmed by values of plasmatic and urinary osmolarity and of urinary electrolytes.

Chickenpox↗
PubMed1990

[Laboratory and clinical studies of norfloxacin in pediatric field].

We have carried out laboratory and clinical studies on norfloxacin (NFLX, AM-715). The results are summarized as follows. NFLX was given through oral administration to one child each at dose levels of 1.7 mg/kg, 2.4 mg/kg and 3.2 mg/kg. After administration, peak serum levels of NFLX obtained for the 3 dose levels were 0.16 micrograms/ml at 1 hour, 0.69 micrograms/ml at 2 hours, 0.81 micrograms/ml at 1 hour, respectively, and half-lives were 2.5 hours, 1.8 hours and 2.7 hours, respectively. NFLX was given through oral administration to 2 children at a dose level of 4.4 mg/kg and to another child at a dose level of 4.8 mg/kg. After administration, mean peak serum levels of NFLX obtained were 1.17 +/- 0.48 micrograms/ml and half-lives were 3.0 +/- 0.5 hours. Urinary excretion rates of NFLX were 14.5% and 28.4% in the first 8 hours after administration of 1.7 mg/kg and 3.2 mg/kg, respectively, and 29.1% in the first 6 hours after administration of 2.4 mg/kg. Mean urinary excretion rates of NFLX were 38.5 +/- 13.0% in the first 8 hours after administration of 4.4 mg/kg and 4.8 mg/kg. Treatment with NFLX was made in 33 cases of pediatric bacterial infections including 5 cases of tonsillitis, 14 cases of enteritis, 10 cases of UTI and 1 case each of bronchitis, balanoposthitis, impetigo and pustulosis. Results obtained were excellent in 14 cases, good in 15 cases. No significant side effect due to the drug was observed in any cases.

Adolescent↗
PubMed1989

Mupirocin (2 percent) ointment in the treatment of primary and secondary skin infections.

Mupirocin (2 percent) ointment is a unique topical agent recently developed for use in the treatment of superficial skin infections. It has shown excellent in vitro and in vivo activity against gram-positive staphylococci and streptococci, which are the predominant pathogens in most superficial skin infections, and against gram-negative Hemophilus influenzae and Neisseria gonorrhoeae. At present, mupirocin (2 percent) ointment has been approved for use in the treatment of impetigo, but an analysis of several recent clinical trials has also indicated the potential for mupirocin treatment of other primary and secondary skin infections. Furthermore, because mupirocin apparently has fewer adverse effects than systemic antibiotics, is less expensive, easier to administer, and less likely to induce antibiotic resistance, it should be considered as an alternative to oral agents in the antimicrobial therapy of a variety of primary and secondary skin disorders.

Administration, Oral↗
PubMed1989

Efficacy and safety of 2% mupirocin ointment in the treatment of primary and secondary skin infections--an open multicentre trial.

Staphylococci and beta-haemolytic streptococci are usually responsible for causing common primary and secondary skin infections. Mupirocin (Bactroban, Eismycin; trademarks of Beecham Group plc), a new antibiotic unrelated to any other antibacterial agent and developed for topical use only, shows a high level of activity against these bacteria. In an open multicentre study the efficacy and safety of mupirocin (2% in a polyethylene glycol vehicle) was evaluated in 1,391 general practice patients with superficial skin infections. The most common skin infections treated were pyoderma (eg, impetigo, folliculitis) and secondarily infected skin lesions. Treatment consisted of application of the ointment three times daily for an average of nine days. A total of 1,304 patients were evaluable for post-treatment clinical assessment. At the end of the treatment 961 (73.7 per cent) patients were cured and in 293 (22.5 per cent) patients the symptoms of the infection had markedly improved. In total, 525 bacterial strains were isolated from the wounds of 445 patients, predominantly staphylococci (n = 344) and streptococci (n = 93). Local side effects such as burning, itching and reddening were observed in 39 (2.9 per cent) of 1,357 patients. No evidence of systemic toxicity or abnormal laboratory data was noted. Mupirocin 2% ointment proved to be effective and safe in the treatment of primary and secondary skin infections.

Anti-Bacterial Agents↗
PubMed1989

[Laboratory and clinical studies on clarithromycin in pediatrics].

Clarithromycin (TE-031, A-56268) is a new 14-membered ring macrolide antibiotic developed by Taisho Pharmaceutical Co., Ltd. TE-031 has a methoxy group at position 6 in its structure. In the present study, we carried out laboratory and clinical investigations on TE-031 in the field of pediatrics. The obtained results are summarized as follows. The antibacterial activity of TE-031 was investigated against 16 clinically isolated strains of Streptococcus pyogenes, Staphylococcus aureus, Haemophilus influenzae, Bordetella pertussis and Campylobacter jejuni. TE-031 showed antibacterial activity comparable to erythromycin. The pattern of changes in TE-031 concentrations in the blood after administration was investigated. In subjects administered the granular preparation of TE-031, Cmax values were 0.64 micrograms/ml in 1 subject given a 5 mg/kg dosage, and 5.94 and 9.02 micrograms/ml in 2 subjects administered with 10 mg/kg. The tablet form of TE-031 was administered to 3 subjects at 5 mg/kg, and Cmax values were 2.09-3.92 micrograms/ml, while T 1/2 values were in a range of 2.9-3.8 hours. When drug concentrations in the urine were investigated, it was found that 6-hour recovery rates were 9.9% (dose: 5 mg/kg) and 53.4% (dose: 10 mg/kg) in the subjects administered the granular form, whereas recovery rates averaged 36.8% in the tablet-administered subjects. In the clinical trial, TE-031 was administered in 2-3 doses/day for 2-18 days. In cases given the granular form, dosages were 12-38 mg/kg/day, while tablets were administered at 12-29 mg/kg/day. The overall clinical efficacy rate was 92.8%, i.e., the drug was effective in 64 of 69 patients. TE-031 was ineffective in 1 case of otitis media, but efficacious in 10 of 10 (100%) cases of upper respiratory infection, 15 of 18 (83.3%) cases of bronchitis and pneumonia, 5 of 6 (83.3%) cases of pertussis, 13 of 13 (100%) cases of mycoplasmal pneumonia, 4 of 4 (100%) cases of Chlamydia psittaci pneumonia, 16 of 16 (100%) cases of gastroenteritis (including 15 cases of Campylobacter gastroenteritis), and 1 (100%) case of impetigo. In bacteriological studies conducted on the patients, the overall elimination rate was 93.1%, i.e., bacterial elimination was obtained in 27 of 29 cases. TE-031 showed especially good bacteriological efficacy (100%) against C. jejuni and B. pertussis, which were eliminated from all of 15 and 2 cases examined, respectively.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1989

[Pharmacokinetic and clinical studies on cefmenoxime in neonates and infants].

Pharmacokinetic and clinical studies on cefmenoxime (CMX) in neonates and infants were conducted. 1. CMX 20 mg/kg was administered by intravenous bolus injection to 6 neonates (with ages 2 to 20 days) and 5 infants (with ages 36 to 107 days) and its serum concentration and urinary excretion rates were determined. In the neonates, serum concentrations of CMX after intravenous administration reached peak levels of 48.2 to 90.7 micrograms/ml (mean 70.4 +/- 14.3 micrograms/ml) in 1/4 hour, then declined with half-lives of 1.27 to 5.19 hours (mean 2.28 +/- 1.56 hours), and were 3.6 to 16.9 micrograms/ml (mean 8.3 +/- 6.0 micrograms/ml) at 6 hours. In the infants, serum concentrations at 1/4 hour were 67.5 to 111.0 micrograms/ml (mean 95.5 +/- 18.0 micrograms/ml); half-lives were 0.64 to 0.94 hour (mean 0.81 +/- 0.13 hour); and the serum concentrations at 6 hours were 0.2 to 1.1 micrograms/ml (mean 0.7 +/- 0.4 micrograms/ml). Mean peak serum concentrations in the neonates tended to be lower than those in the infants, but higher than those in children. Regarding the age differences of serum concentrations due to age in the neonates, their peak levels tended to be lower in younger ones. Half-lives were shorter in older subjects and, in early infancy, approached values observed in children. Urinary recovery rates in the first 6 hours after intravenous administration ranged from 43.6 to 87.5% (mean 61.6 +/- 14.6%) in the neonates and from 52.1 to 90.8% (mean 78.0 +/- 15.1%) in the infants. Thus, recovery rates were high even in younger subjects and tended to be higher in older subjects. 2. CMX was administered to 27 neonates and 4 infants to investigate its clinical effect, bacteriological effect and side effects. Clinical efficacy ratings of the drug in 19 neonate cases that could be evaluated (1 with purulent meningitis, 2 with suspected septicemia, 1 with acute bronchitis, 12 with acute pneumonia, 1 with impetigo, 1 with periumbilical abscess and 1 with acute pyelonephritis) were "excellent" in 14 cases, "good" in 4, and "poor" in 1. The efficacy rate covering "excellent" and "good" was 94.7%. In 4 infants (2 with acute pneumonia, 1 with periumbilical abscess and 1 with acute pyelonephritis), "excellent" was obtained in 2 cases and "good" in 2 cases. Thus, all the cases showed "good" or higher ratings. Bacteriologically, 1 strain of Staphylococcus aureus and 3 strains of Escherichia coli in neonates were eradicated while, in infants, 1 strain of S. aureus persisted but 1 of E. coli was eradicated.(ABSTRACT TRUNCATED AT 400 WORDS)

Alanine Transaminase↗
PubMed1989

Bacteriology of pyodermas and antibiograms of pathogens.

One hundred and seventy six cases of various clinical types of pyodermas were investigated to find the causative organism of the disease. Folliculitis formed the largest clinical group followed by infectious eczematoid dermatitis, secondary infection, furuncles, impetigo, ecthyma and carbuncle in descending order of frequency. A total of 189 micro-organisms were isolated from the specimens examined. A single infecting organism was isolated from 74.43% and more than one type of organism from 16.48% of cases. Coagulase positive staphylococcus (73.02%) was the predominant species followed by beta-haemolytic streptococcus (26.98%). Coagulase positive staphylococcus was isolated from 109 (61.93%), beta-haemolytic streptococcus from 22 (12.5%) and both these organisms from 29 (16.48%) cases. The antibiotic resistance pattern showed maximum resistance to penicillin followed by ampicillin. None of the strain was found to be resistant to kanamycin. Low percentage of strains were found to be resistant to streptomycin, oxytetracycline, trimethoprim, cloxacillin, erythromycin, chloramphenicol, cephalexin, gentamycin and neomycin.

Ampicillin↗
PubMed1989

[Atypical dermatomycoses in children as seen in personal observations].

15 cases of cutaneous fungal infection in children with nontypical clinical findings have been presented. The fungal infections simulated other skin diseases particularly atopic dermatitis in 6 cases, diaper dermatitis in 4 cases and in single cases psoriasis, impetigo, purpura, eczema and exudative multiforme erythema. Mycotic examinations have confirmed the fungal character of lesions. The specific treatment resulted in the complete cure of the skin lesions.

Adolescent↗
PubMed1989

[Clinical studies on sulbactam/ampicillin in the field of pediatrics].

During 8 months from October 1986 to May 1987, the clinical efficacy of sulbactam/ampicillin (SBT/ABPC) was evaluated in 63 pediatric inpatients with various infections. Clinical efficacies were evaluable in 58 patients among them (consisting of 2 patients with sepsis, 3 with tonsillitis, 12 with bronchitis, 6 with bronchopneumonia, 24 with pneumonia, 1 with phlegmon, 2 with lymphadenitis, 1 with impetigo and 7 with urinary tract infection) and were excellent in 40 patients and good in 17 with an overall efficacy rate of 98.3%. Bacteriological efficacies were assessed in 25 patients and 27 strains of organisms (consisting of 3 strains of Staphylococcus aureus, 2 Streptococcus pneumoniae, 1 Streptococcus pyogenes, 2 beta-Streptococcus, 1 Gram-positive cocci, 5 Escherichia coli, 1 Enterobacter aerogenes, 7 Haemophilus influenzae, 2 Haemophilus parainfluenzae, 1 Branhamella catarrhalis, 1 Proteus mirabilis and 1 Salmonella subgenus I). Bacteriological eradication rates were 88.9% for Gram-positive organisms, 66.7% for Gram-negative organisms and 74.1% overall. No superinfection was observed in any of patients treated. Side effects and clinical laboratory parameter abnormalities observed consisted of diarrhea in 7 (11.1%) of the 63 patients, eosinophilia in 2 (3.3%) of 61 tested, thrombocytosis in 3 (5.5%) of 55, elevation of direct bilirubin in 1 (3.3%) of 30, elevation of total bilirubin in 1 (3.1%) of 32, elevation of GOT in 4 (6.8%) of 59 and elevation of GPT in 1 (1.7%) of 59 patients tested. As an effect on the hemostatic mechanism of this drug, PIVKA II was detected in 1 patient (4.2%) of 24 tested, but findings of other coagulation tests were normal and none of patients showed bleeding tendency or inhibition of platelet aggregation. From the above results, it appears that SBT/ABPC is an efficacious and safe drug in the treatment of bacterial infections of pediatric patients.

Adolescent↗
PubMed1989

[Overall clinical evaluation of cefpodoxime proxetil against infections in pediatric fields].

Dry syrup and tablet of newly developed cefpodoxime proxetil (CS-807, CPDX-PR) was investigated in the departments of pediatrics of 17 institutes and their related hospitals. 1. Pharmacokinetics of CPDX-PR in pediatrics were investigated. Peak blood levels of CPDX at dose levels of 3 mg/kg and 6 mg/kg were 2.24 +/- 0.21 and 4.68 +/- 0.54 micrograms/ml, respectively, in fasting and 1.65 +/- 0.07 and 3.71 +/- 0.41 micrograms/ml, respectively, after meal. Urinary recovery rates in 6 hours were 31.2 +/- 2.2% of dose in average. 2. Clinical efficacies of CPDX-PR on various infectious diseases were studied in 748 cases. Clinical efficacy rate in 499 cases with causative bacteria isolated was 94.6%: efficacy rates for individual infections were 96.8% (120/124) for tonsillitis, 96.0% (96/100) for urinary tract infection, 93.5% (58/62) for pneumonia, 92.4% (61/66) for impetigo, 100% (32/32) for scarler fever and 93.2% for pharyngitis or laryngitis. Bacteriological eradication rate for Gram-positive organisms was 91.0% (244/268); and for Gram-negative organisms, 89.7% (210/234). The clinical efficacy rate for cases which were non-responsive to previous antibiotic therapy was 88.1% (74/84). 3. Side effects and clinical laboratory findings were investigated in 779 cases. Two each of vomiting, loose stool and rash, 10 of diarrhea and 1 of diarrhea associated with candidiasis were reported, but no serious side effects were noted. There was no serious laboratory test abnormality except slight elevations of eosinophile, platelet, transaminase or prolongation of prothrombin time, totalling 34 occurrences.

Administration, Oral↗
PubMed1989

[Laboratory and clinical studies of sulbactam/ampicillin in pediatric field].

We have carried out laboratory and clinical studies on sulbactam/ampicillin (SBT/ABPC). The results are summarized as follows. SBT/ABPC was given by 30-minute drip infusion to 1 child at a single dose of 15 mg/kg and to 2 children at a single dose of 30 mg/kg. After the 30-minute drip infusion, peak serum levels of ABPC(SBT) obtained for the 2 dose levels were 18.0 micrograms/ml (12.4 micrograms/ml) for the former dose level and 81.0 micrograms/ml (53.7 micrograms/ml) and 300 micrograms/ml (200 micrograms/ml) for the latter at the end of injection, and half-lives were 0.84 hour (0.82 hour) for the former and 0.96 hour (1.44 hours) and 0.93 hour (1.19 hours) for the latter. In another trial, SBT/ABPC was given to 1 child at a single dose of 60 mg/kg. After the 30-minute drip infusion, peak serum level of ABPC (SBT) was 82.3 micrograms/ml (45.9 micrograms/ml), and half-life was 1.20 hours (1.36 hours). The urinary excretion rates of ABPC (SBT) were 51.3% (49.5%), 55.8 +/- 10.4% (65.3 +/- 9.1%), 74.0% (76.1%) up to 6 hours after the 30-minute drip infusion of 15 mg/kg, 30 mg/kg and 60 mg/kg, respectively. Treatment with SBT/ABPC was made in 21 cases of pediatric bacterial infections: 8 cases of tonsillitis, 4 cases of bronchitis, 3 cases of pneumonia and 1 case each of pharyngitis, peritonsillar abscess, lymphadenitis, impetigo, abscess and urinary tract infection. Results obtained were excellent in 14 cases, good in 7 cases. No significant side effect due to the drug was observed in any cases except 1 case of fever and rash.

Age Factors↗
PubMed1978

Child health of Great Barrier Island.

The health of 69 children on Great Barrier Island was studied. This is an isolated community without a permanent doctor, and most children were healthy. Ear disease was the commonest problem, especially in Maori children. Problems of impetigo, scabies, rheumatic fever and dental caries were not present. Comparisons are made with the results of a recent Auckland study.

Adolescent↗
PubMed1989

[Therapeutic effects of cefodizime in the treatment of various infectious diseases in children].

Therapeutic effects of cefodizime (CDZM, THR-221), a new cephalosporin having a methoxyimino group, were examined in various infectious diseases in children. Clinical efficacy rates were 100% (3/3) in pneumonia, 100% (5/5) in acute bronchitis, 75% (3/4) in upper respiratory infections and 100% (1/1) in each of a croup and a mixed infection with Streptococcus pyogenes and staphylococcal impetigo. Hence, the overall efficacy rate was 92.9% (13/14). Adverse effects were observed in 2 cases, i.e. exanthema provably due to drug allergy in 1 case and a slightly elevated GPT in another. Changes in serum concentrations and urinary excretion of CDZM were examined in a child with no infection. T 1/2 values obtained were 124.5 minutes (bioassay) and 143.4 minutes (high performance liquid chromatography (HPLC]. Eight hour recovery rates in urine were 62.9% (bioassay) and 65.4% (HPLC). CDZM was considered to be a safe and useful drug in treating various infectious diseases in children.

Adolescent↗