dibekacin and Digestive-System-Diseases

We examined the clinical features of 14 men (mean age 72 years) with postoperative enteritis caused by methicillin-resistant Staphylococcus aureus (MRSA). The patients had all undergone surgery for the treatment of digestive diseases and had received antibiotic prophylaxis consisting of an extended-spectrum cephem. Diarrhea appeared a mean of 3.3 days postoperatively and lasted for 5 days on average. In severe cases organ insufficiency was involved. Coagulate-positive staphylococci were the predominant organisms isolated from watery diarrhea. In 13 of 14 patients, coagulase type II isolates producing enterotoxins A, C and toxic shock syndrome toxin-1 (TSST-1) with enterotoxin A, C, and 1st genes were isolated. These strains were sensitive to vancomycin and arbekacin; however, they were highly resistant to many other antibiotics. We also investigated the effects of a glucocorticoid hormone and gamma globulin on production of tumor necrosis factor-alpha (TNF-alpha) and interleukin-2 (IL-2) obtained from healthy volunteers. TNF-alpha and IL-2 production was enhanced by TSST-1 and the supernatant of Iscove-modified dulbecco medium, in which coagulase type II isolates producing enterotoxins A, C and TSST-1 with enterotoxin A, C were cultured for 24 h. Both glucocorticoid hormone and gamma globulin suppressed TNF-alpha and IL-2 production, thus suggesting that these drugs may be effective in treating postoperative MRSA enteritis.

Topics: Aged; Aged, 80 and over; Anti-Bacterial Agents; Dibekacin; Digestive System Diseases; Enteritis; Enterotoxins; Glucocorticoids; Humans; Immunoglobulin G; In Vitro Techniques; Interleukin-2; Male; Methicillin Resistance; Middle Aged; Postoperative Complications; Shock, Septic; Staphylococcal Infections; Staphylococcus aureus; Tumor Necrosis Factor-alpha; Vancomycin

Cefoxitin (CFX) was administrated to a total of 12 hospitalized patients with digestive diseases, in combination with aminoglycosides. The following results were obtained: Clinical effects of CFX on 12 cases were "excellent" in 4 cases, "good" in 5, "fair" in 1 and "unknown" in 2, with the efficacy rate of 75%. All 4 cases who developed septicemia with underlying severe diseases showed "excellent" effect to CFX. Clinical results of 8 cases with hepatic biliary tract infections were "good" in 5, "fair" in 1 and "unknown" in 2, with the efficacy rate in 62.5%. As for side effects, an allergic reaction was observed in 1 case, and it is suggested renal function should be monitored carefully in a case of combination use with aminoglycosides.

Topics: Aged; Bacterial Infections; Biliary Tract Diseases; Cefoxitin; Cholecystitis; Dibekacin; Digestive System Diseases; Drug Therapy, Combination; Female; Gallstones; Gentamicins; Humans; Liver Abscess; Male; Middle Aged; Sepsis