cefotaxime and Abscess

Tuberculosis, with its varied presentations and numerous complications, is a relatively common disease in developing countries like India. Amongst its many presentations, pulmonary tuberculosis is the commonest. A tubercular laryngeal abscess is an extremely rare entity. We report a 37-year-old male, diagnosed with a tubercular laryngeal abscess which was successfully treated under local anaesthesia by incision and drainage and in whom a tracheostomy could be avoided.

Topics: Abscess; Adult; Antitubercular Agents; Cefotaxime; Diclofenac; Drainage; Ethambutol; Humans; Hydrocortisone; Isoniazid; Laryngoscopy; Male; Pyrazinamide; Rifampin; Tomography, X-Ray Computed; Tuberculosis, Laryngeal

The introduction of antibiotics in the treatment of suppurative otitis media has significantly decreased the incidence of complications. Reports of Bezold's abscess secondary to this disorder are rare, particularly in infants and young children, in whom mastoid bone pneumatization is not yet complete. We present a case of Bezold's abscess occurring in a child aged 18 months. The literature is reviewed and methods to accurately diagnose this complication are emphasized.

Topics: Abscess; Cefotaxime; Follow-Up Studies; Humans; Infant; Infusions, Intravenous; Mastoiditis; Otolaryngology; Risk Assessment; Tomography, X-Ray Computed; Treatment Outcome

A case of spleen abscess complicating Salmonella bacteremia in a HIV-infected patient is reported for the first time. Chronic pancreatitis and the infection of a pre-existing pseudocyst of the pancreas tail might have been the predisposing factor. Infection developed before other AIDS criteria were evident in the patient. Splenectomy plus antibiotic therapy was required to eradicate the process. Salmonella enteritidis was cultured from two suppurated lesions of the excised organ.

Topics: Abscess; Adult; Cefotaxime; HIV Infections; HIV-1; Humans; Male; Salmonella enteritidis; Salmonella Infections; Splenectomy; Splenic Diseases; Ultrasonography

The purpose of this study was to examine the safety and efficacy of outpatient intravenous antibiotic therapy for skin and soft-tissue infections and determine its effect on length of hospital stay. In this open-label, multicenter, prospective study, 130 adult patients with skin and soft-tissue infections requiring parenteral antibiotic therapy were enrolled as a subgroup. Initial therapy was delivered to hospital inpatients or in outpatient treatment centers, followed by home infusion therapy. Cefotaxime was delivered intravenously using a programmable ambulatory infusion pump. The clinical response rate was 97.5% (n = 118), while the bacteriologic response rate was 94.0% (n = 83). Only 32.2% of patients required hospitalization, and the mean duration of inpatient care for all evaluable patients was only 1.5 days. The mean duration of hospitalization for patients receiving inpatient care was 4.7 days. In conclusion, home intravenous cefotaxime therapy is safe, effective, and may reduce healthcare costs for many patients with skin and soft-tissue infections.

Topics: Abscess; Adult; Bacterial Infections; Cefotaxime; Cellulitis; Diabetes Complications; Female; Home Care Services; Humans; Infusion Pumps; Length of Stay; Male; Middle Aged; Prospective Studies; Skin Diseases, Bacterial

To compare the efficiency of antibioprophylaxis by cefazolin sodium or cefotaxime sodium, 3137 consecutive patients undergoing abdominal surgery were included in a prospective, randomized, controlled, multicenter study. The patients were divided into four strata, according to the degree of contamination during the operation and the risk factors. Within each stratum, the patients were randomized into three groups of treatment: (1) cefazolin, (2) cefotaxime, and (3) nontreatment (control). Antibiotics were administered perioperatively in three intravenous doses of 1 g at eight-hour intervals. Patients undergoing colon surgery or with peritonitis at the time of the operation were excluded from the study. The wound abscess rate was significantly lower in the treated groups than in the control group, except in stratum 3 (contaminated surgery). The percentage of postoperative peritonitis was twice as low in the treated groups as in the control group. There was no difference between the groups receiving cefazolin or cefotaxime. The patients in the treated groups received significantly less postoperative antibiotics than the patients in the control group. In terms of cost, antibioprophylaxis by cefazolin seems to be warranted in all operations with a low anaerobic contamination.

Topics: Abdomen; Abscess; Adult; Cefazolin; Cefotaxime; Female; Humans; Infection Control; Intraoperative Period; Male; Middle Aged; Multicenter Studies as Topic; Postoperative Complications; Premedication; Prospective Studies; Random Allocation; Surgical Wound Infection

Topics: Abscess; Adult; Aged; Amoxicillin; Breast Diseases; Cefotaxime; Ceftriaxone; Clinical Trials as Topic; Doxycycline; Drug Combinations; Endometritis; Erythromycin; Female; Genital Diseases, Female; Humans; Metronidazole; Middle Aged; Postoperative Complications; Pregnancy; Puerperal Infection; Salpingitis; Urinary Tract Infections

During a 7 month trial for therapy of polymicrobial surgical sepsis, intravenous antibiotic treatment was randomized between gentamicin (1 mg/kg every 8 hours) plus clindamycin (8 mg/kg every 6 hours), and the cephalosporin, ceftriaxone (1 g every 12 hours) in 197 patients, of whom 99 were being treated for peritonitis, 93 for soft tissue sepsis, and 5 for other forms of infection. No significant differences were noted in patient demographics, type of sepsis, associated disease states, surgical procedure, or causative aerobic or anaerobic pathogens. Results demonstrated approximately equivalent efficacy, although cure rates obtained with ceftriaxone in patients with soft tissue sepsis or intraabdominal abscess were superior to those achieved with combination gentamicin and clindamycin. There were no significant side effects with ceftriaxone therapy, such as the renal failure noted in six of the patients treated with gentamicin and clindamycin. We conclude that single agent treatment with ceftriaxone is preferable because of the greater safety and the longer dosing intervals.

Topics: Abdomen; Abscess; Adolescent; Adult; Aged; Bacterial Infections; Cefotaxime; Ceftriaxone; Clindamycin; Clinical Trials as Topic; Drug Therapy, Combination; Female; Gentamicins; Humans; Kidney Diseases; Male; Microbial Sensitivity Tests; Middle Aged; Peritonitis; Postoperative Complications; Random Allocation; Recurrence

During 31 months of study, 808 patients with polymicrobial surgical infection were randomized for antibiotic therapy between a third-generation cephalosporin (moxalactam disodium [149], cefotaxime sodium [125], and cefoperazone sodium [141]) and the combination of gentamicin sulfate plus clindamycin (393). Results based on antibiotic therapy included the following: cure in 83% given cephalosporin, 73% with antibiotic combination; control but recurrent sepsis in 7% and 15%; and failure in 4% and 8%, respectively. Such data support the tenet that third-generation cephalosporins are at least equal, if not superior, to the combination of gentamicin plus clindamycin for treatment of polymicrobial surgical sepsis.

Topics: Abscess; Adolescent; Adult; Aged; Bacteria; Bacterial Infections; Cefoperazone; Cefotaxime; Cephalosporins; Cephamycins; Child; Clindamycin; Clinical Trials as Topic; Female; Gentamicins; Humans; Kidney Diseases; Male; Middle Aged; Moxalactam; Peritoneal Diseases; Peritonitis; Postoperative Complications; Random Allocation; Surgical Wound Infection

The objective is to determine whether a medical treatment, the combination of cefotaxime and rifampicin, is effective in avoiding surgery for managing deep cervical abscesses in children and to determine prognostic factors in the efficacy of this medical treatment. This is a retrospective analysis of all patients under 18 presenting with para- or retro-pharyngeal abscess over the period 2010-2020 in two hospitals' pediatric otorhinolaryngology departments. One hundred six records were included. Multivariate analyses were performed to study the relationship between the prescription of the Cefotaxime-rifampicin protocol at the onset of the management and the use of surgery and to evaluate the prognostic factors of its efficacy. The 53 patients who received the cefotaxime-rifampicin protocol as first-line treatment (vs. 53 patients receiving a different protocol) required surgery less frequently: 7.5% versus 32.1%, validated by a Kaplan-Meier survival curve and a Cox model analysis adjusted for age and abscess size (Hazard Ratio = 0.21). This good outcome of the cefotaxime-rifampicin protocol was not demonstrated when it was instituted as a second-line treatment after the failure of a different protocol. An abscess larger than 32 mm at hospitalization was significantly associated with more frequent use of surgery in multivariate analysis adjusted for age and sex (Hazard Ratio = 8.5).    Conclusions: The cefotaxime-rifampicin protocol appears to be an effective first-line treatment in managing non-complicated deep cervical abscesses in children. What is Known: • Nowadays, medical treatment is preferred for managing deep neck abscesses in children. There has yet to be a consensus on the antibiotic therapy to be proposed. • Staphylococcus aureus and streptococci are the most frequent causative organisms. What is New: • The cefotaxime-rifampicin protocol introduced at first intention is effective, with only 7.5% of patients requiring drainage surgery. • The only risk factor for failure of the medical treatment is the initial size of the abscess.

Topics: Abscess; Anti-Bacterial Agents; Cefotaxime; Child; Drainage; Humans; Neck; Retrospective Studies; Rifampin

Prevotella species (i. e. P. intermedia, P. nigrescens, P. pallens, P. oris) are usually responsible for abscesses of head and neck spaces after dental procedures. P. intermedia - related infective endocarditis has never been reported.. A 22-year-old man, with a history of aortic valve replacement 6 years ago, presented with fever and persistent retrosternal chest pain. An empirical antibiotic therapy was started on (cefotaxime, 2gx3 - gentamicin, 5mg/kilo). Five blood cultures were positive at Prevotella Intermedia. Metronidazole was introduced (500mg X 3 by day).The oro-pharyngeal spaces were normal. The evolution was marked by a hypotension, a third degree atrio-ventricular block, and a rapidly growing aortic root abscess complicated this case of Prevotella Intermedia infective endocarditis (IE). Aortic valve redux surgery was performed at day 5 of admission. Post-operative course was unremarkable.. This first reported case of Prevotella Intermedia IE presented suggestive features of anaerobic IE as the patient developed both aortic-ring abscess, third degree atrio-ventricular block and hypotension.

Topics: Abscess; Adult; Anti-Bacterial Agents; Aortic Valve; Cefotaxime; Endocarditis; Endocarditis, Bacterial; Gentamicins; Heart Valve Prosthesis; Humans; Hypotension; Male; Metronidazole; Prevotella intermedia; Young Adult

Topics: Abdominal Pain; Abscess; Anti-Bacterial Agents; Cefazolin; Cefotaxime; Child, Preschool; Drainage; Fever; Humans; Kidney; Kidney Diseases; Male; Pyelonephritis; Staphylococcus aureus; Tomography, X-Ray Computed; Vancomycin

Acute osteomyelitis of the clavicle accounts for less than 3% of osteomyelitis cases, with its usual location in the middle third. It may be hematogenous, due to contiguity, or secondary to catheterization of the subclavian vein or neck surgery. The diagnosis is often delayed, and clinical symptoms may simulate obstetric brachial plexus palsy in young children. We report a new case of osteomyelitis of the clavicle in a 30-day-old newborn.

Topics: Abscess; Administration, Oral; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Catheterization, Central Venous; Cefotaxime; Clavicle; Female; Fever of Unknown Origin; Follow-Up Studies; Fosfomycin; Fractures, Spontaneous; Haemophilus Infections; Haemophilus influenzae; Humans; Infant; Infant, Newborn; Infectious Disease Transmission, Vertical; Infusions, Intravenous; Male; Osteomyelitis; Pregnancy; Pregnancy Complications, Infectious; Radionuclide Imaging; Sepsis; Streptococcal Infections; Ultrasonography

Periorbital infection following pansinusitis is a rare complication which can lead to irreversible orbital and intracranial consequences. Chandler classified them in 1970.. An eight-year-old child presented with a subperiosteal superolateral abscess. The initial flu-like syndrome developed into pansinusitis resisting to usual treatment. Palpebral edema and major exophthalmia then appeared requiring CT scan and MRI, which confirmed a subperiosteal abscess.. A subperiosteal abscess is a serious condition requiring an early diagnosis and a medical or surgical treatment adapted to the severity. Chandler's classification gives the opportunity to adapt management to the infection's gravity. Ethmoiditis may be complicated by periorbital abscesses found usually in the superointernal quadrant. Medical imaging and surgical treatment confirmed a superolateral periorbital abscess and a frontal mucocele. This case illustrates the possibility of communication between frontal sinus and orbital cavity. During frontal sinus infection, pre-existing mucocele may become super-infected and induce a periorbital abscess.

Topics: Abscess; Anti-Bacterial Agents; Cefotaxime; Child; Drainage; Drug Combinations; Exophthalmos; Frontal Sinusitis; Humans; Magnetic Resonance Imaging; Male; Metronidazole; Mucocele; Orbital Cellulitis; Radiography; Vancomycin

We report an unusual case of a 6-year-old boy with a sinus tract terminating with an intramedullary dermoid cyst and holocord central lesion, presenting with tetraparesis secondary to intramedullary abscess. Total excision of dermal sinus tract, dermoid cyst, and the intramedullary abscess by means of a L2-S3 laminectomy, followed by antibiotic therapy resulted in good functional recovery. Strengths of the upper extremities have fully recovered, and a remarkable improvement was detected in the muscles of the lower extremities. Postoperative magnetic resonance imaging (MRI) of the spine showed complete removal of the dermoid cyst, decreased inflamed granulation tissue over the medullary conus, and disappearance of the holocord high intensity lesion. The pathomechanism of holocord central lesion is discussed herein.

Topics: Abscess; Cefotaxime; Child; Dermoid Cyst; Drug Therapy, Combination; Follow-Up Studies; Gram-Negative Bacterial Infections; Humans; Laminectomy; Lumbar Vertebrae; Magnetic Resonance Imaging; Male; Metronidazole; Neurologic Examination; Postoperative Care; Postoperative Complications; Quadriplegia; Sacrum; Spina Bifida Occulta; Spinal Cord; Spinal Cord Neoplasms; Vancomycin

Soft tissue involvement is an unusual presenting feature for children with meningococcal infection. We describe 2 children, 1 with conjunctivitis and another with a thyroglossal duct cyst abscess associated with Neisseria meningitidis, and review previous reports of these entities to emphasize the broad spectrum of meningococcal disease and pertinent aspects of treatment and of prophylaxis of contacts.

Topics: Abscess; Anti-Bacterial Agents; Cefotaxime; Child; Conjunctivitis, Bacterial; Humans; Infant; Male; Meningococcal Infections; Neisseria meningitidis; Thyroglossal Cyst

Topics: Abscess; Anti-Bacterial Agents; Cefotaxime; Child; Combined Modality Therapy; Drainage; Feces; Gastroenteritis; Humans; Lymphadenitis; Male; Salmonella enteritidis; Salmonella Infections; Sternum; Thoracic Wall

Occasionally, trivial odontogenic infections may develop into complex diseases. This may even result in an unrestrained phlegmonous spread causing life-threatening complications. These problems have decreased since the introduction of antibiotics and also due to improved oral hygiene and improved diagnostic measures resulting in optimized medical treatment. However, life-threatening forms are still seen, in particular if infections spread along the cervical fascial sheaths down towards to the mediastinum. Over the past decade the number of critical infections has increased in other medical specialties. This is usually explained by the development of multiresistant pathogens in the context of nosocomial infections.. We reviewed the patients' records of the past 15 years at the Department of Oral and Maxillofacial Surgery of the University Hospital Kiel to assess a possible increase of odontogenic infections with life-threatening complications. From 1990 to 2004, four patients with odontogenic infections exhibiting critical phlegmonous spread were treated in the intensive care unit. Two patients developed bacterial mediastinitis which could be controlled by intravenous antibiotics only. One patient progressed to general septic mediastinitis and eventually died of cardiorespiratory arrest. The last patient also had septic mediastinitis and developed right pleural empyema. Several operations were necessary before the disease could be controlled. This patient's case report is presented in detail.. The prognosis of patients with mediastinitis crucially depends on (a) early diagnosis including computed tomography of the neck and thorax, (b) early radical surgical intervention, and (c) optimized pathogen-oriented antibiotic treatment.

Topics: Abscess; Ampicillin; Cefotaxime; Cellulitis; Combined Modality Therapy; Critical Care; Disease Progression; Empyema, Pleural; Follow-Up Studies; Humans; Male; Mediastinitis; Middle Aged; Neck; Reoperation; Shock, Septic; Staphylococcal Infections; Staphylococcus epidermidis; Streptococcal Infections; Sulbactam; Therapeutic Irrigation; Thoracotomy; Tomography, X-Ray Computed; Vancomycin

With antibiotics and an increasing dental care and hygiene, the profound neck spaces infections have decreased their incidence. Nevertheless we can found them in the clinical practice, and they present a big morbidity and severe complications. We present in this paper a case of profound cervical abscess in a diabetic patient, discussing the clinical and therapeutics aspects.

Topics: Abscess; Aged; Anti-Bacterial Agents; Cefotaxime; Diabetes Complications; Diabetes Mellitus; Enterobacteriaceae Infections; Humans; Male; Streptococcal Infections; Submandibular Gland Diseases; Tomography, X-Ray Computed

Topics: Abscess; Amikacin; Amphotericin B; Cefotaxime; Choroid Diseases; Drug Therapy, Combination; Eye Infections, Bacterial; Fluorescein Angiography; Humans; Kidney Transplantation; Male; Middle Aged; Nocardia asteroides; Nocardia Infections; Transplantation, Homologous; Trimethoprim, Sulfamethoxazole Drug Combination; Vitreous Body

Endophthalmitis subsequent to Klebsiella sepsis leads to functional blindness in most cases and is very difficult to treat. Every successful therapeutic modality can therefore help in creating an optimal therapeutic plan.. A 69-year old diabetic patient exhibited bilateral Klebsiella endophthalmitis with sepsis after a pneumonia. Two intravenous antibiotics were used: aminoglycosides (Gentamycin) and cephalosporins (Cefotaxim or Cefuroxim) with local parabulbar injections of Prednisolon. The long-term follow-up of four years provided some overview of morphological aspects of the development of endophthalmitis. Characteristic greyish hypopyon was seen in both eyes, which was more pronounced in the left eye than in the right. The left eye became phthisic. After resorption of the hypopyon in the right eye and prolonged resorption of the subretinal abscess for 9 months a useful visual acuity at 0.2 was achieved. Two years after the endophthalmitis a cataract surgery with implantation of a posterior chamber silicon lens was performed and good visual acuity (0.6) was achieved. After four years, the subretinal abscess left an extremely large, sharp bordered, unpigmented scar up to the sclera.. An early diagnosis and adequate long-time antibiotic therapy under the co-operative supervision of an ophthalmologist with internist appears to be most important for the therapeutic success in Klebsiella endophthalmitis.

Topics: Abscess; Aged; Cefotaxime; Cefuroxime; Drug Therapy, Combination; Endophthalmitis; Follow-Up Studies; Gentamicins; Humans; Klebsiella Infections; Lenses, Intraocular; Long-Term Care; Male; Ophthalmoscopy; Pneumonia, Bacterial; Prednisolone; Retinal Diseases; Sepsis

A case of a periappendiceal actinomycosis, seen in an 83-year-old woman, clinically mimicking a right ovarian neoplasm penetrating the right colon, is presented. The patient's complaints led to the discovery of a right abdominal mass. Explorative laparotomy and right hemicolectomy were done. Histological examination revealed periappendiceal actinomycotic abscesses. We discuss a possible pathogenesis and the therapeutic modalities.

Topics: Abscess; Actinomyces; Actinomycosis; Aged; Aged, 80 and over; Anti-Bacterial Agents; Appendectomy; Appendix; Cecal Diseases; Cefotaxime; Diagnosis, Differential; Drug Therapy, Combination; Female; Humans; Metronidazole; Ovarian Neoplasms; Tomography, X-Ray Computed

A full-term neonate with a history of umbilical venous catheterization followed by coagulase-negative staphylococcal sepsis is presented. The infant developed a solitary hepatic abscess with saprophytic organisms. Her liver abscess resulted in acute glomerulonephritis characterized by hypertension, proteinuria, oliguria, and azotemia. Surgical drainage and antibiotic treatment of the abscess was associated with resolution of the glomerulonephritis. Glomerulonephritis due to solitary liver abscess in a neonate has not been reported previously. Acute onset of glomerulonephritis should prompt a search for occult sources of infection.

Topics: Abscess; Anti-Bacterial Agents; Bacterial Infections; Cefotaxime; Cephalosporins; Drainage; Drug Therapy, Combination; Female; Glomerulonephritis; Humans; Infant, Newborn; Liver Diseases; Magnetic Resonance Imaging; Micrococcus; Staphylococcal Infections; Vancomycin

Topics: Abscess; Acute Disease; Cefotaxime; Cephalosporins; Combined Modality Therapy; Disease Progression; Exudates and Transudates; Female; Humans; Infant; Injections, Intravenous; Mastoiditis; Middle Ear Ventilation; Streptococcal Infections; Streptococcus pneumoniae; Suction; Tomography, X-Ray Computed; Treatment Outcome

Spinal epidural abscess (SEA) is rare in children, especially in newborns and infants, groups in which only very few cases have been reported. Because of the nonspecificity of presenting symptoms in children the diagnosis may be delayed, resulting in major permanent neurological deficits. In this paper, we report a case of cervical SEA in a 6-week-old infant who initially presented with fever and developed quadriparesis 19 days prior to admission. After emergency anterior decompression of the abscess the neurological function was improved immediately. Five months after surgery the neurological status was normal, an MR study showing disappearance of the epidural abscess and spinal cord indentation, and progressive fusion of the C3, C4 and C5 vertebral bodies. Anterior decompression without bone graft can provide an excellent prognosis in case of an anterior cervical SEA in infants.

Topics: Abscess; Cefotaxime; Cervical Vertebrae; Drug Therapy, Combination; Epidural Space; Female; Hip Joint; Humans; Infant; Radiography; Spinal Diseases; Spinal Fusion; Staphylococcal Infections; Treatment Outcome; Vancomycin

A case of retroperitoneal pulmonary fistula caused by a neonatal adrenal abscess is reported. The adrenal abscess was diagnosed by means of needle aspiration which guided the choice of antibiotic therapy. The fistula was demonstrated by direct injection of contrast medium into the adrenal abscess. Treatment by needle aspiration of the adrenal abscess and intravenous antibiotics was successful.

Topics: Abscess; Adrenal Gland Diseases; Anti-Bacterial Agents; Bronchial Fistula; Cefotaxime; Cephalosporins; Contrast Media; Escherichia coli Infections; Fistula; Gentamicins; Humans; Infant, Newborn; Injections, Intravenous; Lung Diseases; Male; Needles; Netilmicin; Suction; Tomography, X-Ray Computed

Topics: Abscess; Bacteremia; beta-Lactam Resistance; beta-Lactamases; Cefepime; Cefotaxime; Ceftazidime; Cephalosporin Resistance; Cephalosporins; Drug Resistance, Microbial; Enterobacter; Enterobacteriaceae Infections; Humans; Mutation; Pneumonia, Bacterial

A case of paraspinal abscess formation from Haemophilus paraphrophilus is presented.. To describe a case of paraspinal abscess formation from H. paraphrophilus, a fastidious commensal organism of the mouth and pharynx. A precise bacteriologic identification can be difficult; techniques for such identification are discussed.. Spinal abscess caused by H. paraphrophilus is unusual and can be very difficult to diagnose.. The etiology, clinical presentation, technical examinations, and treatment are reviewed.. Prolonged antibiotic treatment was curative, although surgery was considered.. Bacteriologic diagnoses in these rare infections are difficult. Antibiotic therapy was curative in the patient described.

Topics: Abscess; Anti-Infective Agents; Cefotaxime; Cephalosporins; Ciprofloxacin; Drug Therapy, Combination; Female; Haemophilus; Haemophilus Infections; Humans; Lumbar Vertebrae; Magnetic Resonance Imaging; Middle Aged; Spinal Diseases

Haemophilus aphrophilus is rarely implicated as an aetiology of spinal epidural abscess. A 73-year-old woman with liver cirrhosis who developed H. aphrophilus bacteraemia complicated with vertebral osteomyelitis and spinal epidural abscess is presented. Without surgical decompression, she was successfully treated with cefotaxime for 3 weeks, followed by maintenance with ciprofloxacin for another 10 weeks. The clinical features of eight previously reported cases of vertebral osteomyelitis without epidural abscess due to H. aphrophilus are reviewed.

Topics: Abscess; Aged; Bacteremia; Cefotaxime; Ciprofloxacin; Epidural Space; Female; Haemophilus; Haemophilus Infections; Histocytochemistry; Humans; Liver Cirrhosis; Magnetic Resonance Imaging; Osteomyelitis; Spinal Diseases

The work is based on lymphogenous methods of treatment, i.e. direct endolymphatic therapy with antibiotics and other agents in complications of acute appendicitis. On the basis of information in the literature, among the antibiotics we chose gentamicin, claforan, and a new antibiotic fortum. In addition to antibiotics, for the correction of disturbed blood rheological properties we gave endolymphatic infusions of trasylol, aspisol, and trental. The purpose of our study was the development of methods and treatment of complications of acute appendicitis. In view of this, we chose the patients according to the nosological groups with appendicular infiltrate, appendicular abscesses, and localized peritonitis of appendicular origin.

Topics: Abscess; Acute Disease; Anti-Bacterial Agents; Appendicitis; Aprotinin; Aspirin; Cefotaxime; Ceftazidime; Drug Therapy, Combination; Gentamicins; Humans; Infusions, Intravenous; Lymphatic System; Lysine; Pentoxifylline; Peritonitis; Platelet Aggregation Inhibitors; Premedication

Pituitary abscesses are rare. The case reported here concerns a 28-year old African. Gradual development of diplopia over 6 months was the first clinical manifestation. Three months later this development had reached a more severe and infectious context, with complete right ophthalmoplegia, meningitis and coma (GCS = 9). CT scan showed an image in favour of a pituitary abscess with suprasellar extension, associated with thrombophlebitis of the cavernous sinus. An antibiotic therapy consisting of cefotaxime and metronidazole administered for 1 month, and netilmicin for 15 days succeeded in controlling the infectious syndrome. This resulted in cure of visual disorders, reduction in size of the CT scan image and reconstruction of the pituitary sella which had been destroyed. The diagnosis of pituitary abscess should be made when confronted with an infectious syndrome (unexplained fever, repeated meningitis). CT does not recognize the nature of the hypophyseal mass it shows: necrosis of a pituitary adenoma, giant aneurysm or craniopharyngioma may mimic local infection. Surgery confirms the diagnosis and is regarded as the best treatment. The patient's life is threatened when meningitis is present, and the functional prognosis is poor when recovery from visual disorders is compromised due to late diagnosis. In this paper a comparative analysis of the clinical course of the disease and therapeutic data in our patient is presented and compared with other reported cases.

Topics: Abscess; Adult; Cefotaxime; Diplopia; Drug Therapy, Combination; Humans; Male; Metronidazole; Netilmicin; Pituitary Diseases; Sella Turcica; Tomography, X-Ray Computed

Cat-scratch disease is considered in the differential diagnosis of benign regional lymphadenopathy. We describe a case of cat-scratch disease in a 12-year-old boy with multiple bony, hepatic and splenic lesions which resolved with chemotherapy. The present case with simultaneous multiorgan involvement supports the view of a systemic nature of the disease.

Topics: Abscess; Cat-Scratch Disease; Cefotaxime; Child; Humans; Liver Abscess; Male; Osteolysis; Splenic Diseases

A case is reported of splenic abscess due to Eikenella corrodens, a gram-negative rod which is found as part of normal flora in human mucous surfaces. A 64-year-old man presented with fever, chills, anorexia and abdominal pain. Abdominal ultrasound examination showed a perisplenic fluid collection which was considered to be either blood or a subcapsular spleen abscess. The presence of a splenic abscess was later confirmed during surgery and a splenectomy was performed. Splenic purulent material and blood cultures yielded Eikenella corrodens. The patient received cefotaxime for 19 days and was discharged asymptomatic.

Topics: Abscess; Cefotaxime; Eikenella corrodens; Gram-Negative Bacterial Infections; Humans; Male; Middle Aged; Spleen; Splenectomy; Splenic Diseases

Aminoglycoside activity is suppressed under conditions of low pH and oxygen tension that are likely to occur in infected tissues; the suppressive effects of these conditions are additive. Under aerobic conditions, the MIC of amikacin for 10 isolates of Escherichia coli was 4.8 +/- 0.7 micrograms/ml at pH 7.2 and increased to 40.0 +/- 8.2 micrograms/ml at pH 6.0. Under anaerobic conditions, the MIC of amikacin for E. coli was 30.0 +/- 1.5 micrograms/ml at pH 7.2 and greater than 50.0 micrograms/ml at pH 6.0. In vitro and in vivo studies of amikacin activity in an acidic and hypoxic milieu containing beta-lactamase demonstrated substantially enhanced bactericidal activity when amikacin and beta-lactams were used together. Under conditions of reduced pH and oxygen tension, cefotaxime enhanced [3H]-tobramycin uptake by E. coli 14-fold and [3H]amikacin uptake 7-fold and appeared to overcome the suppressive effect of those conditions on uptake of aminoglycosides by bacteria.

Topics: Abscess; Aerobiosis; Amikacin; Anaerobiosis; Animals; Anti-Bacterial Agents; Bacteroides fragilis; Cefotaxime; Drug Synergism; Enterobacteriaceae; Escherichia coli; Humans; Hydrogen-Ion Concentration; Mice; Oxygen; Pseudomonas aeruginosa; Ticarcillin; Tobramycin

In systemic and local infections, the therapeutic efficacy of cefpirome was compared to that of imipenem and cefotaxime. Murine septicemia induced with methicillin-sensitive and methicillin-resistant Staphylococcus aureus strains responded well to cefpirome and imipenem therapy, the ED50 values ranged from 0.8 to 28.40 mg/kg and 0.5 to 15.58 mg/kg, respectively. The carbapenem also displayed high efficacy against Enterococci and was more potent than cefpirome. Cefotaxime, however, exhibited lower activity or proved to be inactive against these strains. With ED50 values of 0.03 to 31.33 mg/kg, cefpirome was the most active of the three antibiotics in protecting mice challenged with Enterobacteriaceae. The corresponding ED50 values of imipenem and cefotaxime ranged from 0.72 to 70.95 mg/kg and 0.06 to 66.30 mg/kg, respectively. Despite distinctly lower in vitro activity against the infecting organism, cefpirome showed efficacy similar to imipenem in the treatment of subcutaneous S. aureus abscesses in mice. It was more effective than imipenem and cefotaxime against experimental Klebsiella pneumonia in mice and the Escherichia coli infected granuloma pouch in rats.

Topics: Abscess; Animals; Bacterial Infections; Cefotaxime; Cefpirome; Cephalosporins; Enterobacteriaceae Infections; Escherichia coli Infections; Female; Granuloma; Imipenem; Male; Mice; Mice, Hairless; Mice, Inbred C3H; Pneumonia; Rats; Rats, Inbred Strains; Sepsis; Staphylococcal Skin Infections; Staphylococcus aureus; Streptococcal Infections

The therapeutic activity of FCE 22891 was compared with that of two new oral cephalosporins, cefuroxime axetil and cefixime against Streptococcus pneumoniae respiratory infection and subcutaneous abscesses induced by mixed aerobes and anaerobes in mice. In experimental pneumonia FCE 22891 was the most active antibiotic. In aerobic abscesses FCE 22891 proved the most active agent in infections induced by methicillin susceptible and resistant Staphylococcus aureus while all three compounds were very active, against Str. pyogenes. In abscesses caused by Gram-negative bacteria, FCE 22891 showed good and constant efficacy. Cefixime was the most active drug against the two susceptible strains of Escherichia coli and Enterobacter cloacae and also against resistant Esch. coli but was inactive against a strain of Ent. cloacae that produced cephalosporinase. Cefuroxime axetil was less active than the other two drugs against Gram-negative bacteria with adequate efficacy only against a susceptible strain of Ent. cloacae. FCE 22891 was more effective than cefixime and cefuroxime axetil in preventing and reducing the size of abscesses induced by Bacteroides fragilis 101. We conclude that FCE 22891, despite its short half life of 6 min in mice, exerts comparable and sometimes better activity than the two oral cephalosporins characterized by longer half lives.

Topics: Abscess; Animals; Anti-Bacterial Agents; Bacterial Infections; Bacteroides fragilis; Bacteroides Infections; Carbapenems; Cefixime; Cefotaxime; Cefuroxime; Cephalosporins; Female; Half-Life; Lung Diseases; Mice; Microbial Sensitivity Tests; Pneumonia, Pneumococcal

Two groups of rats were treated for epididymitis in an experimental study. The developing infection of E. coli was treated effectively by a single dose of cephalosporin in one group of rats. In the other group, where abscess formation had taken place, no effect of up to 9 days of treatment could be demonstrated, indicating the importance of early antibiotic treatment in bacterial epididymitis.

Topics: Abscess; Animals; Cefotaxime; Epididymitis; Escherichia coli Infections; Male; Rats; Time Factors

The pharmacokinetic and chemotherapeutic properties of the new penem antibiotic HRE 664 (Fig. 1) were evaluated in experimental animals. High and sustained blood and serum levels were achieved following parenteral injection in mice, rats, dogs and monkeys. Half-lives ranged from 27 to 40 minutes in the various species tested. The antibiotic was well distributed in the rodents and penetrated well into tissues and body fluids. At 30 minutes after subcutaneous administration to mice (50 mg/kg), concentrations of between 12.4 and 35.9 micrograms/g were measured in the lungs, liver, heart and kidneys, that is 33 approximately 95% of the corresponding level in murine blood (37.7 micrograms/ml). In experimentally induced infections in mice, HRE 664 displayed good chemotherapeutic activity particularly against septicemias caused by methicillin-sensitive and methicillin-resistant Staphylococcus aureus strains and on abscess formation induced by Bacteroides fragilis. Most of the cephalosporins and other beta-lactam antibiotics exhibited low efficacy against these strains of bacteria.

Topics: Abscess; Animals; Anti-Bacterial Agents; Bacterial Infections; Biological Assay; Cefotaxime; Dogs; Lactams; Macaca; Mice; Rats

Cefmenoxime, a new third-generation cephalosporin, was used as a single drug in the therapy for female genital tract infections. Therapeutic response was considered satisfactory in 21 of 22 cases of pelvic inflammatory disease, six of nine tuboovarian abscesses, two of three severe wound infections, and all five cases of endometritis. Overall, 34 of 39 patients responded. The peak serum antibiotic levels in this study ranged from 15.8 to 64 (average 48.7) micrograms/mL, and the trough level ranged from 0.9 to 4 (average 3.1) micrograms/mL. Cefmenoxime was tested in vitro against 424 isolates of anaerobes including 208 strains of bacteroides of which 80 were Bacteroides fragilis. Cefmenoxime inhibited the growth of 90% or greater of the organisms (minimal inhibitory concentration 90) at less than or equal to 64 micrograms/mL. The minimal inhibitory concentration for 75% of B fragilis was 32 micrograms/mL. This study suggests that cefmenoxime as a single-drug therapy is effective in the treatment of female genital tract infections caused by aerobic (including the gonococcus) and anaerobic bacteria.

Topics: Abscess; Bacterial Infections; Cefmenoxime; Cefotaxime; Endometritis; Fallopian Tubes; Female; Genital Diseases, Female; Humans; Microbial Sensitivity Tests; Ovarian Diseases; Pelvic Inflammatory Disease; Pregnancy; Puerperal Infection; Surgical Wound Infection

Forty-one women with pelvic abscesses complicating salpingitis were treated with parenteral cefotaxime, a newer cephalosporin. Abscesses ranged in size from 4 by 4 to 13 by 15 cm, and in 10 women (24%) they were greater than or equal to 10 cm. Neisseria gonorrhoeae was recovered from the endocervix in 17 women (41%). A mean of 26.7 gm of cefotaxime was given over a mean of 6.5 days, and operation was not required during initial therapy. Only two women (5%) required the addition of another antimicrobial. Chronic pelvic pain and recurrent infection were infrequent during the 31- to 43-month follow-up period. Five women (12%) were readmitted for elective surgical therapy because of persistent or recurrent adnexal mass 1 to 33 months following study entry. Six (15%) women became pregnant and were delivered of their infants a mean of 25 months following cefotaxime therapy.

Topics: Abscess; Adolescent; Adult; Cefotaxime; Drug Evaluation; Female; Humans; Hysterectomy; Peritonitis; Pregnancy; Prospective Studies; Recurrence; Salpingitis; Ultrasonography

Topics: Abscess; Ankle; Cefotaxime; Cyclophosphamide; Erythromycin; Female; Fluorescent Antibody Technique; Humans; Leg; Legionella; Middle Aged; Prednisone; Skin Diseases, Infectious

Cefmenoxime was evaluated in an open trial consisting of 41 patients. Forty infections in 36 patients could be evaluated. Thirteen patients had pyelonephritis due to Escherichia coli (two bacteremic), Pseudomonas aeruginosa, Klebsiella pneumoniae, or Streptococcus faecalis; all improved and 12 of 13 were clinically cured, but one relapse (S. faecalis) occurred at two weeks. Six patients with cystitis due to E. coli, Citrobacter freundii, Serratia marcescens, P. aeruginosa, or S. faecalis all improved, but relapse or reinfection, or both, occurred in five due to P. aeruginosa, S. faecalis, C. fruendii, or E. coli. Neurogenic bladder or other complications were present in five of 13 patients with pyelonephritis and five of six with cystitis. Ten patients with pneumonia and one with tracheobronchitis due to Hemophilus influenzae, S. pneumoniae, S. agalactiae, or Neisseria meningitidis all improved and seven had resolution without relapse, but P. aeruginosa emerged in two patients, one of whom died. Eight soft tissue infections due to Staphylococcus aureus, Peptococcus prevotti, Streptococcus species, or infections of mixed origin resolved in six. Sterility of blood cultures was obtained in one patient with endocarditis due to S. anginosus, but other therapy was substituted. Clinical resolution of the toxic shock syndrome and subsequent negative endocervical cultures for S. aureus occurred in one. Granulocytopenia of unverified cause in four (with less than 1,500 mm3) and two (with less than 2,000 mm3) was reversible. Headache during treatment occurred in six patients and a possible disulfiram-like effect in three. Elevations of serum glutamic oxalacetic transaminase and alkaline phosphatase occurred in five, Coombs' positivity in two, and diarrhea in three. Clinical efficacy of cefmenoxime was significant. Possible side effects require further study.

Topics: Abscess; Adolescent; Adult; Aged; Bacterial Infections; Cefmenoxime; Cefotaxime; Cellulitis; Cystitis; Drug Resistance, Microbial; Enterobacteriaceae Infections; Female; Humans; Leukopenia; Male; Microbial Sensitivity Tests; Middle Aged; Pneumonia; Urinary Tract Infections

The in vivo antibacterial activity and the penetration into inflammatory tissues of cefoperazone (CPZ) were compared with those of cefotiam (CTM) in local infection systems using mouse subcutaneous abscess and rat granuloma pouch. The serum levels of CPZ in subcutaneous abscess in mice caused by Staphylococcus aureus F-230 (penicillinase producing strain) were lower than that of CTM, but there was no significance between the therapeutic effects of both drugs. The same results were obtained using Staphylococcus aureus F-196 (penicillinase non-producing strain). When infected with Enterobacter cloacae H-27 (cephalosporinase producing strain) in rat granuloma pouch, the exudate levels of CTM were lower than those of CPZ. Judging from these results, it was suggested that CPZ was a useful antibiotic for the treatment of bacterial-inflammatory tissues.

Topics: Abscess; Animals; Bacterial Infections; Cefoperazone; Cefotaxime; Cefotiam; Drug Evaluation, Preclinical; Male; Mice; Rats

The therapeutic efficacy of ceftriaxone and gentamicin was investigated in a foreign body induced abscess model in the rat by implanting a dialysis tube contaminated with Klebsiella pneumoniae into the subcutaneous tissue. Animals were treated for four days with ceftriaxone, gentamicin, and their combination starting immediately following or 48 h after the implantation. Peak free ceftriaxone and gentamicin abscess fluid levels were 4.3 and 2.6 mcg/ml, which were 7.3% and 37.5% of peak blood levels respectively. Both agents persisted longer in abscess fluid than in blood. Ceftriaxone inhibited the development of abscess formation when administered shortly after the implantation of the contaminated foreign body whereas gentamicin alone was without beneficial effect. When administered after 48 h ceftriaxone was less effective than immediately after implantation and gentamicin was again without any therapeutic effect. The effect of the combination of ceftriaxone and gentamicin was slightly better than ceftriaxone alone. Low oxygen tension may be an explanation for the lack of bactericidal effect of gentamicin. Ceftriaxone may be more suitable for the therapy of closed space infections caused by susceptible microorganisms than gentamicin.

Topics: Abscess; Animals; Cefotaxime; Ceftriaxone; Disease Models, Animal; Drug Evaluation, Preclinical; Drug Therapy, Combination; Female; Gentamicins; Kinetics; Klebsiella Infections; Klebsiella pneumoniae; Male; Rats; Rats, Inbred Strains

Topics: Abscess; Adult; Aged; Arthritis, Infectious; Bacterial Infections; Cefotaxime; Cephalosporins; Cholangitis; Female; Humans; Male; Middle Aged; Otitis Media; Pelvic Inflammatory Disease; Pharyngitis; Urinary Tract Infections

Topics: Abscess; Adolescent; Adult; Cefotaxime; Cephalosporins; Endometritis; Female; Humans; Middle Aged; Pelvic Inflammatory Disease; Sepsis