cefotaxime and Acquired-Immunodeficiency-Syndrome

To describe the design and first-round survey results of a trial of intensive sexually transmitted disease (STD) control to reduce HIV-1 incidence.. Randomized, controlled, community-based trial in Rakai District, Uganda.. In this ongoing study, 56 communities were grouped into 10 clusters designed to encompass social/sexual networks; clusters within blocks were randomly assigned to the intervention or control arm. Every 10 months, all consenting resident adults aged 15-59 years are visited in the home for interview and sample collection (serological sample, urine, and, in the case of women, self-administered vaginal swabs). Sera are tested for HIV-1, syphilis, gonorrhea, chlamydia, trichomonas and bacterial vaginosis. Following interview, all consenting adults are offered directly observed, single oral dose treatment (STD treatment in the intervention arm, anthelminthic and iron-folate in the control arm). Treatment is administered irrespective of symptoms or laboratory testing (mass treatment strategy). Both arms receive identical health education, condom and serological counseling services.. In the first home visit round, the study enrolled 5834 intervention and 5784 control arm subjects. Compliance with interview, sample collection and treatment was high in both arms (over 90%). Study arm populations were comparable with respect to sociodemographic and behavioral characteristics, and baseline HIV and STD rates. The latter were high: 16.9% of all subjects were HIV-positive, 10.0% had syphilis, and 23.8% of women had trichomonas and 50.9% had bacterial vaginosis.. Testing the effects of STD control on AIDS prevention is feasible in this Ugandan setting.. An ongoing (1994-98) randomized, community-based trial in Uganda's Rakai District is assessing the assumption that intensive sexually transmitted disease (STD) control efforts result in marked declines in HIV/AIDS prevalence. Described, in this article, are the project design and findings of the first-round baseline survey. 56 communities were grouped into 10 clusters designed to encompass social/sexual networks and clusters within blocks were randomly assigned to the intervention or control arm. All consenting permanent residents of the district are visited in their homes at 10-month intervals where they are administered extensive questionnaires, provide urine and vaginal swab samples, and are offered mass treatment regardless of symptoms or laboratory testing (single oral dose STD treatment in the intervention arm and anthelmintics and iron folate in the control arm). Both groups receive identical health education, condom promotion, and serologic counseling services. In the first round of home visits, 5834 intervention and 5784 control arm subjects were enrolled, representing about 90% of eligible adults. The groups were comparable in terms of sociodemographic and behavioral characteristics and baseline rates of HIV and STDs. 16.9% of subjects were HIV-positive, 10.0% had syphilis, 23.8% of women had trichomonas, and 50.9% had bacterial vaginosis. Detailed STD assessment is expected not only to document the relationship between STD control and HIV, but also to identify which STDs confer the greatest population attributable risk for HIV transmission, facilitating targeted control efforts in the future.

Topics: Acquired Immunodeficiency Syndrome; Administration, Oral; Adolescent; Adult; Anti-Infective Agents; Azithromycin; Cefixime; Cefotaxime; Ciprofloxacin; Female; HIV-1; Humans; Incidence; Injections, Intramuscular; Male; Metronidazole; Middle Aged; Penicillin G Benzathine; Prevalence; Sexual Behavior; Sexually Transmitted Diseases; Single-Blind Method; Uganda

The purpose of this study was to determine the safety and efficacy of home intravenous antibiotic therapy in treating secondary bacterial infections in patients infected with the human immunodeficiency virus (HIV). This study was a subset analysis of 22 patients with HIV, enrolled in two centers of a multicenter, open-label, prospective study. When necessary, patients were stabilized as inpatients, followed by home therapy. Enrolled patients had diagnoses of pneumonia, skin and soft-tissue infections, bacteremia/septicemia, or other infections requiring parenteral therapy. A third-generation cephalosporin, cefotaxime, 1-2 g every 8 hours, was delivered intravenously using an ambulatory delivery system (ADS). Home therapy with cefotaxime/ADS produced a clinical response rate of 95% and bacteriologic response of 88.2%. The requirement for and duration of inpatient therapy was markedly reduced compared with diagnosis-related group (DRG) allotments. In conclusion, home intravenous antibiotic therapy with cefotaxime in patients infected with HIV is effective and safe. It may improve quality of life by reducing the length of hospital stay.

Topics: Acquired Immunodeficiency Syndrome; Adult; Bacterial Infections; Cefotaxime; Female; Home Care Services; Humans; Infusion Pumps; Length of Stay; Male; Prospective Studies

Topics: Acquired Immunodeficiency Syndrome; Anti-Bacterial Agents; Antiretroviral Therapy, Highly Active; Cambodia; Cefotaxime; Child; Drug Resistance, Bacterial; Enterobacter; Enterobacteriaceae Infections; HIV Infections; Humans; Klebsiella; Klebsiella Infections; Opportunistic Infections

Topics: Acquired Immunodeficiency Syndrome; Adjuvants, Immunologic; Aged; Anti-Bacterial Agents; Bacteria; Cefotaxime; Humans; Immunity; Immunocompromised Host; Immunologic Deficiency Syndromes; Immunologic Factors; Phagocytosis

Topics: Acquired Immunodeficiency Syndrome; Adult; Cefotaxime; Humans; Liver Abscess; Male; Salmonella Infections; Salmonella typhimurium