minocycline and flomoxef

We report two cases of severe bronchopneumonia due to influenza A (H3N2) virus. The severity of the disease necessitated initiation of empiric therapy based on the present illness and clinical data on admission. Both patients were improved by artificial ventilation with positive end-expiratory pressures and administration of broad spectrum antibiotics and corticosteroids before confirming the diagnosis of viral bronchopneumonia using viral culture and serological tests. Within 24 hours, influenza A (H3N2) virus was identified by amplification of the pathogen genes by reverse transcription polymerase chain reaction (RT-PCR) using the stored bronchoalveolar lavage (BAL) fluids of both cases. This suggests that a combination of detection methods of pathogens using RT-PCR and BAL fluid will facilitate determination of rational treatment aimed at influenza A virus.

Topics: Aged; Antibiotic Prophylaxis; Betamethasone; Bronchoalveolar Lavage Fluid; Bronchopneumonia; Cephalosporins; Clindamycin; Combined Modality Therapy; Drug Therapy, Combination; Fosfomycin; Humans; Influenza A virus; Influenza A Virus, H3N2 Subtype; Male; Methylprednisolone; Middle Aged; Minocycline; Pneumonia, Viral; Positive-Pressure Respiration; Respiration, Artificial; Reverse Transcriptase Polymerase Chain Reaction; RNA, Viral

Out of 110 strains of Staphylococcus aureus isolated from 1985 to 1990, isolation rate of methicillin-resistant S. aureus (MRSA) was investigated. Nineteen strains of 59 S. aureus from outpatients and 20 strains of 51 S. aureus from inpatients were determined as MRSA. Isolation frequency of MRSA from inpatients was increasing in the recent two years. Coagulase type, enterotoxin type and production of toxic shock syndrome toxin-1 (TSST-1) were examined in 22 strains of MRSA. Coagulase type II (86%), enterotoxin type C (68%) and TSST-1 positive strain was most dominant. Susceptibility of MRSA to 4 antimicrobial agents were measured, MRSA were sensitive to vancomycin (VCM), arbekacin (ABK) and minocycline, but resistant to flomoxef. Thirty-four patients from whom MRSA was isolated including 20 patients from urine, 13 from pus and 1 from blood, were analyzed clinically. Pyuria was not recognized in some cases in whom MRSA was isolated from their urine. Concomitant polymicrobial infection was frequently noted in those patients with MRSA in their urinary tract. These facts show that the pathogenic role of MRSA in the urinary tract infection was not significant. On the other hand, when MRSA was isolated from pus or blood, serious infections could be caused by MRSA, especially in compromised host. Regarding the treatment in these cases, administration of VCM or ABK was though to be necessary.

Topics: Aminoglycosides; Anti-Bacterial Agents; Cephalosporins; Dibekacin; Humans; Immunocompromised Host; Methicillin Resistance; Minocycline; Serotyping; Staphylococcus aureus; Urologic Diseases; Vancomycin

The influence of Mueller-Hinton (MH) broth (from BBL Microbiology Systems, and Difco Laboratories) of minimum inhibitory concentrations (MIC) of cefuzoname (CZON), flomoxef (FMOX), imipenem (IPM), and minocycline (MINO) for 100 strains of Staphylococcus aureus was investigated. Antibacterial activity of MINO was stronger than any other antibiotics. MICs of CZON for 16 strains (14 of 50 methicillin-resistant S. aureus (MRSA), 2 of 50 methicillin-sensitive S. aureus) were greater than or equal to 4-fold greater when tested in BBL MH broth than when tested in Difco MH broth, thus, different media altered categories of some strains (8 of 50 MRSA) from susceptible to resistant. MICs of FMOX in the BBL MH broth for 12 of 50 MRSA strains rose greater than or equal to 4-fold compared to the Difco MH broth. On the other hand, MICs of IPM and MINO were affected very little by the different brand of MH broth used.

Topics: Ceftizoxime; Cephalosporins; Culture Media; Drug Resistance, Microbial; Imipenem; Minocycline; Staphylococcus aureus; Tetracyclines