cefotaxime and Rupture--Spontaneous

This prospective, randomized, double-blind study compares the efficacy, safety and cost-effectiveness of ampicillin, gentamicin and clindamycin (AGC) or cefotaxime and clindamycin (CC) for the treatment of children with complicated appendicitis. Ninety-seven children were randomized. Forty-seven were assigned to the AGC regimen and 50 received CC. Forty-two patients in the AGC group had an appropriate therapeutic outcome, whereas 48 of 50 children who received CC completed the trial successfully (p = NS). There were no differences between the groups with reference to the duration of antibiotic administration, fever, leukocytosis or length of hospitalization. Complications of therapy were uncommon and neither regimen demonstrated a significant advantage from an economic standpoint. We concluded that, in childhood, complicated appendicitis can be treated with either CC or AGC with equal efficacy.

Topics: Adolescent; Ampicillin; Appendicitis; Cefotaxime; Child; Child, Preschool; Clindamycin; Combined Modality Therapy; Cost-Benefit Analysis; Double-Blind Method; Drug Administration Schedule; Drug Therapy, Combination; Female; Gentamicins; Humans; Intestinal Perforation; Male; Premedication; Prospective Studies; Rupture, Spontaneous; Surgical Wound Infection

The occurrence of an amebic liver abscess (ALA) rupturing into the stomach is reported. ALAs in children can have atypical presentations, resulting in delayed diagnosis and increased morbidity and mortality. Timely treatment is usually followed by complete recovery.

Topics: Amebicides; Anti-Infective Agents; Biopsy; Cefotaxime; Cephalosporins; Chemotherapy, Adjuvant; Child, Preschool; Female; Fever; Humans; Iodoquinol; Liver Abscess, Amebic; Melena; Metronidazole; Rupture, Spontaneous; Stomach Rupture

Three patients with spontaneous rupture of the oesophagus (Boerhaave's syndrome) were successfully treated by a conservative regimen consisting of nil orally and broad-spectrum antibiotics, while their nutrition was satisfactorily maintained by jejunostomy feeding. Such a regimen is simpler and cheaper than one utilising parenteral nutrition: it avoids its complications and limitations, and will enable healing to take place within three weeks after the rupture has occurred. It is therefore suggested that the conservative management of Boerhaave's syndrome is the treatment of choice.

Topics: Adult; Cefotaxime; Drug Therapy, Combination; Enteral Nutrition; Esophageal Diseases; Humans; Jejunostomy; Male; Metronidazole; Middle Aged; Rupture, Spontaneous

The treatment of the patients with ruptured cerebral aneurysm in acute stage is performed by direct neck clipping and cisternal drainages for preventing vasospasm. The cisternal drainage is carried out for 1 to 2 weeks' duration. The cisternal drainage has higher risk for bacterial infections in the cerebrospinal fluid (CSF). In this paper, penetration characteristics of cefotiam (CTM) in CSF were studied. CTM concentrations in CSF were measured at 1, 3 and 6 hours after intravenous drip infusion of CTM (2 g). CTM concentration in cisternal CSF was higher than that of ventricular CSF. The peak concentration in CSF was higher than 0.78 micrograms/ml and obtained at 3 hours after intravenous drip infusion. Our data suggest that CTM is a useful cephalosporin for treatment of meningitis (Staphylococcus aureus, Streptococcus pneumoniae et al.). Apart from meningitis, the higher concentration of CTM in CSF was obtained in the cases with the vasospasm. The result may support that the breakdown of blood brain barrier is induced by the peroxidative substance from the cisternal subarachnoid clots which has the vasospastic activity.

Topics: Acute Disease; Adult; Aged; Cefotaxime; Cefotiam; Drainage; Female; Humans; Intracranial Aneurysm; Ischemic Attack, Transient; Kinetics; Male; Meningitis; Middle Aged; Rupture, Spontaneous