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PubMed1999

[The control leprous peripheral neuropathy and chemotherapy].

Clarithromycin(CAM), Roxithromycin(RXM), Minocycline(MINO) and Fosfomycin(FOM) has anti-inflammatory action and immunomodulatory activity, while the anti-mycobacterium leprae activity is shown. CAM and RXM suppress the rat carrageenin edema, and MINO suppresses the rat adjvant arthritis. There is the immunosuppression on adrenocorticosteroid while the inflammatory cytokine is suppressed. CAM, MINO, FOM suppresses the inflammatory cytokine, while it has the immunomodulatory activity. Fusidic acid(FA) suppresses the inflammatory cytokine with the action of being similar to cyclosporin A, and it has the immunomodulatory activity. New macrolides derivatives, CAM and RXM showed the inflammatory regulation, and MINO showed the anti-inflammatory activity with FA. The combination chemotherapy can be enforced, while peripheral neuropathy is prevented by the control of the leprosy reaction.

Adjuvants, Immunologic↗
PubMed1999

[A case report of urinary tract infection and meningitis caused by methicillin-resistant Staphylococcus aureus (MRSA) after transurethral resection of the prostate].

We present a case of meningitis that developed following a urinary tract infection caused by methicillin-resistant Staphylococcus aureus (MRSA) after transurethral resection of the prostate. The patient, a 69-year-old man with diabetes mellitis, underwent transurethral resection of the prostate following a diagnosis of benign prostatic hypertrophy. On the 4 th day after surgery, high fever occurred immediately after the removal of the indwelling urethral catheter. Cultures of urine and blood revealed MRSA. On the 6 th day after surgery, severe lumbago was evident and MRSA was isolated from cerebrospinal fluid. Separate administration of arbekacin or vancomycin, to which the isolated MRSA was sensitive, was not effective. Combined therapy with fosfomycin, vancomycin and human immunoglobulin effectively relieved the inflammation. Although it is generally reported that the pathogenicity of MRSA is low in the urinary tract, this case suggests that a urinary tract infection caused by MRSA can advance to sepsis and meningitis.

Aged↗
PubMed1998

[Pneumoperitoneum with systemic sclerosis].

We report a case of systemic sclerosis (SSc) complicated with benign pneumoperitoneum without apparent pneumatosis cystoides intestinalis (PCI). A 43-year-old woman was admitted to our hospital because of prominent abdominal distension in April 1997. Raynaud's phenomenon has been detected since 1991. She was suffering from recurrent diarrhea, constipation, and subileus. The diagnosis of SSc was made in 1996 based on the sclerosis in her face, forearms, and chest, and hypomotility of the esophagus. On admission, she presented no signs of peritoneal irritation. The laboratory data revealed that white blood cell count was 7,400/mm3 and C-reactive protein was 0.1 mg/dl. Chest and abdominal roentgenograms showed massive free air under the diaphragm, dilatation of small and large intestine, and air-fluid level. PCI was not apparent. Pneumoperitoneum was improved after four weeks with intravenous hyperalimentation. But she presented recurrent severe diarrhea and high fever whenever she tried to take food orally. Klebsiella pneumoniae was proved in her jejunal juice by bacteriologic examination. Intravenous prostaglandin F2 alpha and oral fosfomycin calcium intake made her condition better. Benign pneumoperitoneum without PCI is rarely reported in the patients with SSc. In her condition, weakness of intestinal wall, hypomotility of intestine, unusual bacterial overgrowth, and elevated intraluminal pressure made intraluminal gas go through the wall of the fragile intestine of SSc. As operation of intestine of SSc usually cause miserable outcome, pneumoperitoneum accompanied with SSc even if PCI is apparent or not must be treated with conventional manner while there is no signs of peritoneal irritation.

Adult↗
PubMed1999

[In vitro antibacterial activity of faropenem, a novel oral penem antibiotic, against enterohemorrhagic Escherichia coli O157 strains].

Against enterohemorrhagic Escherichia coli (EHEC) O157 clinically isolated, the effects of faropenem (FRPM), a novel oral penem antibiotic, on the MICs, bactericidal activity, verotoxin (VT)-release, and lipopolysaccharide (LPS)-release were investigated in vitro and compared with those of other types of antibacterial agents. The MICs of FRPM in aerobic and anaerobic culture condition, were 0.78 and 0.39 microgram/ml, respectively. In aerobic condition, FRPM was more active than ampicillin, amoxicillin (AMPC), fosfomycin (FOM), kanamycin (KM), minocycline (MINO), and clarithromycin (CAM), but was slightly less active than cefdinir (CFDN), cefditoren (CDTR), and norfloxacin (NFLX) against O157 clinical isolates. In anaerobic condition, however, FRPM showed as strong activity as CFDN, CDTR, and NFLX. FOM, NFLX, and KM as well as the beta-lactams including FRPM indicated the powerful bactericidal activity against one strain of O157 clinical isolates. The effects of MINO and CAM were bacteriostatic. FOM and the beta-lactams including FRPM promoted verotoxin type 1 (VT1)-release, but rather suppressed verotoxin type 2 (VT2)-release from the same isolate. NFLX, however, promoted VT1-release and vast amount of VT2-release. In the case of KM, MINO, and CAM, the release suppression of both VT1 and VT2 was observed. FRPM, AMPC, and FOM had very weak activity on LPS-release, while CFDN, CDTR, and NFLX released a large amount of LPS from the strain. KM, MINO, and CAM had relatively weak activity. In these in vitro experiments, FRPM demonstrated the effective profile to the treatment for EHEC infection, except for the effect on VT1-release. These results suggest the possibility that FRPM shows good clinical efficacy for EHEC infection.

Amoxicillin↗
PubMed2002

[Treatment in initial stage of VTEC infection].

Verocytotoxin producing Escherichia coli(VTEC) causes gastrointestinal infections worldwide. In at most 8% of the children in Japan who are infected with VTEC, hemolytic-uremic syndrome(HUS) develops soon after the onset of diarrhea. Treatment with antibiotics does not ameliorate VTEC infections, and in some studies from western countries, it has been associated with worse clinical outcomes. It was recently indicated in Japan that early administration of fosfomycin to the patients with VTEC infection can decrease the risk of HUS. Moreover, early administration of Synsorb-Pk with high affinity to verocytotoxin to the patients with gastrointestinal VTEC infection was demonstrated to decrease the incidence of very mild and mild HUS, but it did not decrease the risk of moderate and severe HUS. In the developing stage of HUS, intravenous administration of fluid and electrolytes should be determined cautiously to prevent hyponatremia and systemic congestion.

Animals↗
PubMedDate not supplied

[In vitro antibacterial activity of a halogenated derivative of D-alanine].

The "in vitro" effect of beta-chloro-D-alanine, a drug that inhibits cell-wall synthesis, was studied. We used some strains of microorganisms, mainly Gram-negative and resistant to antibiotics with the same mechanism of action. MIC and MBC values obtained show a poor efficacy of this drug. Therefore we studied the association of beta-chloro-D-alanine with ampicillin and fosfomycin. The evaluation of the results, determined by means of a graphic and a mathematical method, shows a good synergistic effect with both associations. Synergism is more marked with ampicillin.

Alanine↗
PubMed2003

[Successful treatment of MRSA-associated glomerulonephritis with antibiotic therapy].

We report a case of methicillin-resistant Staphylococcus aureus (MRSA)-associated glomerulonephritis treated with antibiotic therapy. A 67-year-old man was admitted to our hospital because of proteinuria, hematuria, purpura, and high fever one month after a graft replacement of an abdominal aortic aneurysm. MRSA was detected in specimens of his blood, sputum, and joint fluid. Before his operation, he had shown no renal abnormalities. He presented with a rapid deterioration of renal function following MRSA infection. Maximum level of proteinuria was 1.5 g/day, serum creatinine (Cr) was 3.5 mg/dl, and blood urea nitrogen was 57 mg/dl. Renal biopsy revealed necrotizing crescentic glomerulonephritis. Immunofluorescence examination showed IgA and C3 deposits. Clinical and pathological examinations showed the typical features of MRSA-associated glomerulonephritis. Vancomycin and fosfomycin were administered intravenously. The serum level of C-reactive protein fell from 22.0 mg/dl to 0.1 mg/dl. Proteinuria also decreased and the patient's renal function improved in parallel with the decreased activity of MRSA infection. After three months of antibiotic treatment, proteinuria was negative and the level of serum Cr had dropped to 0.9 mg/dl. These findings suggest that antibiotic treatment can lead to complete remission of MRSA-associated glomerulonephritis.

Aged↗
PubMed1992

Treatment of relapsing peritonitis in pediatric patients on peritoneal dialysis.

Relapsing peritonitis is often due to bacterial colonization of the Tenckhoff catheter and may require removal of the catheter in patients on peritoneal dialysis. The efficacy of a Tenckhoff catheter decontamination procedure was examined in 9 pediatric patients aged 1.5-18 years and compared to the outcome of a historical control group. After repeated dialysate cultures had become negative and cell count was normalized (< 100/ul), intraluminal urokinase (5000 IU/ml) and intraluminal high concentrated antibiotics (vancomycin, fosfomycin, cefotaxim) were instilled sequentially for 3 h and 1 h respectively. This procedure was performed once daily for three days. In addition, the connector was exchanged on the last day. This regimen prevented relapsing peritonitis in all study patients, whereas in the control group in 75.8% of events further relapses occurred, necessitating removal of the Tenckhoff catheter in 7/19 (36.8%) episodes. No side effects of intraluminal urokinase were recorded in any of the patients. We conclude that intraluminal urokinase and intraluminal high concentrated antibiotics combined with connector device exchange are highly effective for prevention of further relapses of peritonitis and reduce the need for Tenckhoff catheter exchange.

Adolescent↗
PubMed1992

[Urinary tract infection in women in daily clinical practice].

Questions concerning the clinical picture, diagnosis and treatment of uncomplicated urinary tract infections in women related to daily practice are discussed on the basis of personal experience and a review of the literature. Indications and rationale for a single-dose therapy with Cotrimoxazole, Trimethoprim or Fosfomycin are detailed. Special considerations are given to therapeutical approaches to recurrent infection as well as special situations like asymptomatic bacteriuria, acute urethral syndrome, bacteriuria in pregnancy and nosocomial, catheter-associated infections are discussed.

Algorithms↗
PubMed2005

[Are we being threatened by multiresistant strains of Staphylococcus aureus?].

Multiresistant strains of Staphylococcus aureus (MRSA) are characterized by their virulence and clinical resistance to all known beta-lactam antibiotics. Furthermore, the representatives of most other classes of antibiotics are also proving to be no longer effective. While infections with the usual S. aureus strains can mostly be readily managed with penicillinase-resistant penicillins, the rescue antibiotic vancomycin, as also teicoplanin, in combination with, for example fosfomycin, are required in the treatment of MRSA and S. epidermidis infections. Since infections with S. aureus/MRSA are usually of endogenous origin, decolonization with mupirocin-containing nasal ointment applied as a prophylactic measure in patients with high colonization rates and/or immunosuppression, is of major importance. The best protection against further spread of highly resistant germs, such as MRSA is, in particular, profession hygiene management.

Aged↗
PubMed1990

[Bacterial combination effect between carumonam and eight other antibiotics].

In vitro interactions between carumonam (CRMN) and 8 other antibiotics were studied using the agar dilution checkerboard technique against 88 clinical isolates of Escherichia coli, Proteus vulgaris, Serratia marcescens and Pseudomonas aeruginosa. Combinations of CRMN with 8 other antibiotics were generally additive or indifferent. Synergism was found against S. marcescens or P. aeruginosa with CRMN plus fosfomycin, gentamicin (GM) or dibekacin. Antagonism was not observed with CRMN plus any of the 8 other antibiotics tested. In a phase-contrast microscopic study, the synergism of CRMN in combination with GM were confirmed against P. aeruginosa 15846. CRMN in combination with GM demonstrated a in vivo synergy against experimental urinary tract infection caused by P. aeruginosa 15846 in mice. We think that combinations of several antibiotics with CRMN should be appropriate for initial therapy of infections because no antagonism appeared to occur with other antibiotic agents.

Animals↗
PubMed1990

MRSA meningitis in postoperative patients. Report of 4 cases.

Four cases of postoperative meningitis caused by methicillin-resistant Staphylococcus aureus (MRSA) are reported together with a review of the literature. These 4 cases were treated successfully by intravenous administration of minomycin, fosfomycin, and cefmetazole. Factors associated with the development of meningitis included multiple craniotomies, the presence of ventricular drainage or a ventriculo-peritoneal shunt, and irradiation.

Adult↗
PubMedDate not supplied

Campylobacter fetus infection of abdominal aortic aneurysm.

A 61-year-old man with Campylobacter fetus infection of an abdominal aortic aneurysm treated surgically is presented herein, the fifth survival case reported in the literature. Fever and back pain preceded the enlargement of atherosclerotic abdominal aortic aneurysm. The patient tolerated satisfactorily total excision of the aneurysm followed by axillo-femoral prosthetic bypass. Antibiotic therapy consisted of intravenous infusion of fosfomycin and gentamicin and oral administration of minocycline. The organism cultured from the aneurysmal wall and intraluminal thrombi was identified as Campylobacter fetus from its typical characteristics. It is concluded that this organism should be considered in all cases of infected aneurysm in elderly or debilitated patients.

Aneurysm, Infected↗
PubMed1989

[Comparative study of cell walls of group A Streptococcus and its non-adhesive phosphomycin-resistant mutant].

The cell wall composition of nonadhesive fosfomycin-resistant mutant of group A streptococcus and highly adhesive wild strain have been studied. The cell wall of the mutant nonadhesive strain contained significantly reduced amounts of lipoteichoic acid and surface proteins as compared to the wild strain, did not contain surface lipoteichoic acid, and, possibly, differed in peptidoglycan-polysaccharide bonding. No differences in the qualitative carbohydrate composition of the cell walls were found. The amino acid composition of the cell walls of these microorganisms differed only in alanine content, which correlates with the reduction of lipoteichoic acid content in the mutant strain. The structural similarity of peptidoglycans of the two strains is demonstrated.

Amino Acids↗
PubMed1989

[Measurement of creatinine clearance and urinary NAG for the evaluation of cis-platinum induced nephrotoxicity].

Creatinine clearance and beta-D-acetyl-glucosaminidase (NAG) were useful markers for the evaluation of the renal function of 57 cases of head and neck cancer treated with 60 mg/m2 cis-platinum (CDDP). There was a significant correlation between creatinine clearance and NAG values for (r = -0.4820, p less than 0.01). The nadir of creatinine clearance and NAG values were observed between 2 and 3 weeks after administration of CDDP. After 2 courses of chemotherapy with CDDP, more nephrotoxicity was observed in the cases received prior CDDP therapy, than cases without chemotherapy statistically. Combined chemotherapy with CDDP and 5-FU (CF therapy) caused more renal damage, comparing with other combined chemotherapy such as COP therapy (CDDP, vincristine and peplomycin), and CAP therapy (CDDP, aclacinomycin and cyclophosphamide). Early recovery from the renal damage following CDDP therapy was detected in the cases given Fosfomycin (FOM). This results suggest that FOM would be effective for decreasing the nephrotoxicity by CDDP.

Acetylglucosaminidase↗
PubMed1988

[Antibiotherapy in gangrene of the perineum].

Fifty cases of extensive and necrotizing perineal cellulitis ("perineal gangrene") are reported. The disease, remarkable for its many anatomical and bacteriological varieties, is regarded as a therapeutic requiring multidisciplinary management. Bacteriological samples were polymicrobial in 40 cases. Streptococcus D and aerobic Gram-negative bacilli were isolated in 21 patients. The initial antibiotic treatment had to be modified on ten occasions in 36 patients who were given penicillin G in high doses and on five occasions in 14 patients who received a beta-lactam antibiotic active against anaerobes. Nineteen patients (38 p. 100) died; death was directly related to the sepsis in 16 cases. The death rate was the same in the two treatment groups (11/36 and 5/14) and similar to that found in the literature. The authors advocate an ureidopenicillin, fosfomycin and imidazole combination as a substitute for the conventional penicillin G, aminoglycoside, imidazole combination, since the former is active against Streptococcus D and has better tissue penetration.

Adult↗
PubMed1988

[Post-antibiotic effect of ciprofloxacin alone and in combination on Streptococcus faecalis].

Post-antibiotic effect (PAE) of ciprofloxacin has been studied on 2 strains of S. faecalis in the logarithmic phase after 2 exposure times and at concentrations ranging 0.5-10 times the MIC. At the end of the exposure period the antimicrobial is removed by dilution. Similar PAE is observed for ciprofloxacin and ofloxacin, higher than for pefloxacin. Ciprofloxacin-fosfomycin or ciprofloxacin-vancomycin combinations are indifferent or even antagonistic (vancomycin) in regards to PAE. Ciprofloxacin-penicillin or ciprofloxacin-netilmicin are weakly synergistic.

Ciprofloxacin↗
PubMed1987

[Synergy, addition, indifference, antagonism and dominance. Dominance and antibiotic combination].

Six strains of Staphylococcus aureus have been studied using an original method which associate the chessboard's technique to that of bactericidal kinetic's. Associations of pefloxacin and rifampicin, vancomycin and fosfomycin are analysed, and result of each concentration's connection is expressed, at 1.5, 3,5 and 24 h, by a three dimensional representation, which facilitate the phenomenon's dynamic. Interpretation of these diagrams can show the classical phenomena of synergy, addition, indifference and antagonism, and also that of domination of an antibiotic in the association. This one can work, by example, by imposing its bactericidal's speed (vancomycin) or by selecting deficient surviving bacteria (rifampicin). This, the intrinsic and sometimes undesirable characteristics of some antibiotics are not masked by the others antibiotics used in the association. This mechanism must be proved in vivo, but it is sure that during physico-chemical inactivity or during diffusion's deficiency of one of antibiotics, transient relation of concentrations are favorable conditions for domination's expression.

Anti-Bacterial Agents↗