cefotaxime and Necrosis

Necrotizing pneumonia induced by Panton-Valentine leukocidin-secreting Staphylococcus aureus is a rare but life-threatening infection that has been described in patients after they had influenza. We report a fatal case of this superinfection in a young adult who had coronavirus disease.

Topics: Adult; Anti-Bacterial Agents; Bacterial Toxins; Betacoronavirus; Cefotaxime; Clindamycin; Clinical Laboratory Techniques; Coronavirus Infections; COVID-19; COVID-19 Testing; Exotoxins; Fatal Outcome; Humans; Leukocidins; Linezolid; Male; Metronidazole; Necrosis; Pandemics; Pneumonia, Staphylococcal; Pneumonia, Viral; Respiration, Artificial; SARS-CoV-2; Spiramycin; Staphylococcus aureus; Tomography, X-Ray Computed

Topics: Anti-Bacterial Agents; Bronchial Fistula; Cefotaxime; Chest Tubes; Combined Modality Therapy; Debridement; Drainage; Drug Therapy, Combination; Empyema, Pleural; Equipment Failure; Female; Humans; Infant; Lung Abscess; Male; Necrosis; Pleural Diseases; Pneumonia, Bacterial; Pneumothorax; Postoperative Complications; Radiography; Respiratory Tract Fistula; Therapeutic Irrigation; Thoracoscopy; Vancomycin

Fournier gangrene is a necrotizing fasciitis of the perineal and genital region, which almost exclusively affects men. The cause is a polymicrobial infection associated with superficial trauma, urological diseases and operations, as well as colorectal diseases. Diabetes mellitus, alcoholism, immunosuppression and other severe illnesses are frequent co-factors. Immediate administration of systemic broad-spectrum antibiotic therapy with coverage of both gram-positive and gram-negative bacteria combined with surgical debridement and intensive medical care can lower the high mortality rate of this condition.

Topics: Adult; Cefotaxime; Combined Modality Therapy; Drug Therapy, Combination; Emergencies; Follow-Up Studies; Fournier Gangrene; Genital Diseases, Male; Humans; Male; Metronidazole; Necrosis; Penile Diseases; Scrotum; Skin; Streptococcal Infections; Streptococcus pyogenes; Tobramycin

Myonecrosis due to Aeromonas spp is exceptional. We report the case of a diabetic patient with liver cirrhosis who developed a rapidly progressive myonecrosis by Aeromonas veronii biotype sobria. The portal of entry was an injury after falling down in an irrigation canal. The outcome was not favourable and surgical amputation of left leg was performed in spite of antibiotic treatment with cefotaxime and tobramicin. Aeromonas spp can be very aggressive and this microorganism should be considered in the differential diagnosis of skin and soft tissue infections with myonecrosis, specially after posttraumatic wound infections with a history of freshwater exposure.

Topics: Aeromonas; Aged, 80 and over; Anti-Bacterial Agents; Cefotaxime; Gram-Negative Bacterial Infections; Humans; Male; Muscular Diseases; Necrosis

The ability of an antibiotic to reach bactericidal concentrations in tissue depends on numerous factors including tissue composition and regional perfusion. Although necrotising pancreatitis is characterised by progression of pancreatic necrosis over at least 96 hours and microcirculatory alterations, the impact of these changes on the concentration of antibiotics in the pancreas has not yet been investigated.. To determine and compare pancreatic tissue concentrations of imipenem and cefotaxime at different stages of acute necrotising pancreatitis in an animal model that has been shown to mimic closely the pathomorphological and bacteriological features of severe human pancreatitis.. Acute necrotising pancreatitis was induced in rats by a standardised intraductal infusion of glycodeoxycholic acid and intravenous cerulein. Six hours (n = 16) and 48 hours (n = 16) after induction of pancreatitis, the animals were randomised for intravenous therapy with either imipenem or cefotaxime. Fifteen minutes after injection of the antibiotic, the animals were killed. Blood and the head of the pancreas were collected for determining imipenem or cefotaxime in serum and tissue; the splenic portion of the pancreas was prepared for histological examination. In an additional set of identically treated animals, pancreatic capillary blood flow (PCBF) was assessed by intravital microscopy before induction of acute necrotising pancreatitis and at the time of antibiotic therapy.. Imipenem accumulates in the pancreas in the initial phase of acute necrotising pancreatitis characterised by pronounced oedema and decreased PCBF, and tends to decrease with resolution of the oedema and the progression of acinar cell necrosis in the later course of the disease. Concentrations of cefotaxime are low in oedematous pancreatic tissue early after induction of acute necrotising pancreatitis and increase with the resolution of oedema and normalisation of PCBF.. Concentrations of antibiotics in the pancreas vary in acute necrotising pancreatitis, depending on changes in pancreatic tissue morphology and capillary blood flow. This suggests that antibiotic tissue concentrations may not be consistent from one agent to another and that efficacy of antibiotics in acute pancreatitis cannot be estimated solely on the basis of their pharmacological and microbiological properties.

Topics: Acute Disease; Animals; Anti-Bacterial Agents; Capillaries; Cefotaxime; Cephalosporins; Disease Progression; Imipenem; Male; Necrosis; Pancreas; Pancreatitis, Acute Necrotizing; Rats; Rats, Sprague-Dawley; Regional Blood Flow; Thienamycins

The authors test antibiotic strategies aimed at either mitigating bacterial translocation from the gut or delivering antibiotics specifically concentrated by the pancreas for prevention of early secondary infection after acute necrotizing pancreatitis.. Infection currently is the principal cause of death after severe pancreatitis. The authors have shown that the risk of bacterial infection correlates directly with the degree of tissue injury in a rodent model of pancreatitis. Bacteria most likely arrive by translocation from the colon.. Severe acute necrotizing pancreatitis was induced in rats by a combination of low-dose controlled intraductal infusion of glycodeoxycholic acid superimposed on intravenous cerulein hyperstimulation. At 6 hours, animals were randomly allocated to five treatment groups: controls, selective gut decontamination (oral antibiotics and cefotaxime), oral antibiotics alone, cefotaxime alone, or imipenem. At 96 hours, surviving animals were killed for quantitative bacterial study of the cecum, pancreas, and kidney.. The 96-hour mortality (35%) was unaffected by any treatment regimen. Cecal gram-negative bacteria were significantly reduced only by the oral antibiotics. Pancreatic infection was significantly reduced by full-gut decontamination and by imipenem, but not by oral antibiotics or by cefotaxime alone. Renal infection was reduced by both intravenous antibiotics.. Early pancreatic infection after acute necrotizing pancreatitis can be reduced with a full-gut decontamination regimen or with an antibiotic concentrated by the pancreas (imipenem) but not by unconcentrated antibiotics of similar spectrum (cefotaxime) or by oral antibiotics alone. These findings suggest that 1) both direct bacterial translocation from the gut and hematogenous seeding interplay in pancreatic infection while hematogenous seeding is dominant at extrapancreatic sites and 2) imipenem may be useful in clinical pancreatitis.

Topics: Acute Disease; Administration, Oral; Amphotericin B; Animals; Bacteria; Bacterial Infections; Bacterial Physiological Phenomena; Cecal Diseases; Cefotaxime; Colistin; Disease Models, Animal; Drug Therapy, Combination; Imipenem; Injections, Intravenous; Kidney Diseases; Male; Necrosis; Pancreas; Pancreatic Diseases; Pancreatitis; Rats; Rats, Sprague-Dawley; Survival Rate; Tobramycin

Necrotizing fasciitis is a potentially fatal, acute bacterial infection characterized by extensive fascial and subcutaneous tissue necrosis. Four factors that contribute significantly to the morbidity and mortality of necrotizing fasciitis are: 1) delayed treatment, due to difficulty in recognizing the condition; 2) inappropriate treatment; 3) host debilitation; and 4) a polymicrobial infection.

Topics: Adult; Bacteroides Infections; Candidiasis; Cefotaxime; Clindamycin; Cloxacillin; Fasciitis; Female; Focal Infection, Dental; Gentamicins; Humans; Metronidazole; Multiple Organ Failure; Neck Muscles; Necrosis; Penicillin G; Periapical Abscess; Shock, Septic; Staphylococcal Infections; Streptococcal Infections; Superinfection

Four local irritation studies of cefodizime sodium (THR-221), a new developed cephem-type antibiotics, were carried out with NZW rabbits. 1. In eye irritation test, 25% THR-221 water solution had no irritancy on eye mucosa in rabbits. 2. In single injective intramuscular irritation study, regardless of solvents (water or 0.5% lidocaine), 25% THR-221 solution had irritancy equal to 0.75% acetic acid. But recovery process of the muscle injured with THR-221 was faster and better than with 0.75% acetic acid. 3. In five days injective muscular irritation study, the irritancy of 25% THR-221 water solution on the muscle was milder than that of CTT or CET. Histopathological damage with THR-221, necrosis/degeneration of muscle fibers and edema/hemorrhage in interstitium etc., were well recovered. 4. In vessel irritation study, 10% or more THR-221 water solution had irritancy on ear vessel. THR-221, as same as CTT, caused organized thrombi and inflammation at the surrounding area. The degree of irritation of 20% THR-221 solution was slightly stronger than that of 20% CET, but weaker than that of 20% CTT. 5. In a clinical phase, it is to be desired that THR-221 like as CTT or CET shall be avoided repeated intramuscular or intravenous injections at the same site.

Topics: Animals; Cefotaxime; Cefotetan; Cephalothin; Edema; Eye; Hemorrhage; Injections, Intramuscular; Injections, Intravenous; Irritants; Male; Mucous Membrane; Muscles; Muscular Diseases; Necrosis; Rabbits; Thrombophlebitis; Veins

Nephrotoxicity of cefodizime sodium (THR-221), a new cephem antibiotic, was studied in rats by comparing its toxic effect with those of other cephem antibiotics including cephaloridine (CER), cefazolin (CEZ) and cefmetazol (CMZ). Each drug was administered single and consecutive 14-day dosage with its alone or in combination with either furosemide or gentamicin. The results are summarized as follows: 1. In the single dosage study, the rats treated with THR-221 at dose levels of 1200 mg/kg and more showed slight changes in urinary protein and glucose. In rats treated with CER at a dose of 1200 mg/kg, creatinine level in plasma and weights of kidneys were increased, and degeneration and/or necrosis of the renal proximal tubular epithelia were observed. Furthermore, by the consecutive dosage of CER at a dose of 1000 mg/kg, remarkable renal responses including increase in urinary protein and glucose, and weights of kidneys, were observed. In addition, histopathological examinations showed degeneration and/or regeneration of the renal proximal tubular epithelia. 2. No enhanced effect of nephrotoxicity by combination with furosemide or gentamicin was observed except in case of combination of CER with furosemide. 3. The above results indicate that the nephrotoxic potency among these four antibiotics on the single and consecutive dosage studies is CER much greater than THR-221 greater than or equal to CEZ = CMZ and CER much greater than THR-221 = CEZ = CMZ, in the decreasing order.

Topics: Animals; Cefazolin; Cefmetazole; Cefotaxime; Cephaloridine; Drug Administration Schedule; Drug Therapy, Combination; Epithelium; Furosemide; Gentamicins; Glycosuria; Injections, Intravenous; Kidney; Kidney Tubules; Male; Necrosis; Organ Size; Proteinuria; Rats; Rats, Inbred Strains

Renal effects of cefodizime sodium (THR-221) administered by the intravenous route singly and for 7 consecutive days to male rabbits, were compared with those of cefazolin sodium (CEZ) and cephalothin sodium (CET). Four animals were used in each group including control groups. In the single-dose study, THR-221 (600 and 1800 mg/kg) and CET (1800 mg/kg) caused no nephrotoxic effects. In the CEZ groups (600 and 1800 mg/kg), findings indicative of the decreased renal function were obtained: serum urea nitrogen and creatinine levels increased over the control values, and phenolsulfonphthalein (PSP) retention test showed a delay in PSP excretion from the blood. In addition, the white surface of the kidney was macroscopically observed, and microscopic examination revealed renal proximal tubular changes such as necrosis, hyaline cast and calcification, suggesting renal disorders. The repeated-dose study also showed similar results to those described above. Administration of THR-221 (200 and 600 mg/kg/day) and CET (600 mg/kg/day) caused no effects on the kidney. In the CEZ groups (200 and 600 mg/kg/day), serum chemical and PSP test results suggested the decreased renal function, and macroscopic and microscopic findings included organic changes in the kidney. These results suggest that under the conditions tested THR-221 dose not elicit signs of nephrotoxicity in contrast to CEZ, and behaves almost equally to CET.

Topics: Animals; Calcinosis; Cefazolin; Cefotaxime; Cephalothin; Drug Administration Schedule; Injections, Intravenous; Kidney; Kidney Diseases; Kidney Function Tests; Kidney Tubules; Male; Necrosis; Rabbits

Topics: Abdominal Muscles; Amikacin; Bacillus; Cefotaxime; Clindamycin; Drug Therapy, Combination; Escherichia coli; Female; Humans; Hysterectomy; Leiomyoma; Metronidazole; Middle Aged; Necrosis; Penicillin G; Peptostreptococcus; Surgical Wound Infection; Uterine Neoplasms

Topics: Animals; Animals, Domestic; Bacterial Infections; Cefotaxime; Ceftizoxime; Dogs; Drug Therapy, Combination; Gram-Negative Bacteria; Humans; Keratitis; Male; Metronidazole; Middle Aged; Necrosis

A 33-week-gestation infant with respiratory distress syndrome is reported. At five days of age, acute life-threatening tracheal obstruction occurred, which was relieved after removal of a plug during bronchoscopy. Histologic examination of the plug revealed partially necrotic tracheal mucosa, compatible with the diagnosis of necrotizing tracheobronchitis. At 31 days of age, obstruction recurred due to the development of a tracheal stricture, which resolved after tracheal reintubation (to maintain patency) and corticosteroid therapy. Tracheal stricture may be a long-term complication of necrotizing tracheobronchitis, when the initial episode does not lead to death from obstruction.

Topics: Bronchitis; Cefotaxime; Dexamethasone; Drug Therapy, Combination; Female; Humans; Infant, Newborn; Infant, Premature, Diseases; Intubation, Intratracheal; Necrosis; Respiratory Distress Syndrome, Newborn; Tracheitis