netilmicin and Osteomyelitis

A case report of anaerobic vertebral osteomyelitis after percutaneous epidural adhesiolysis.. To present a case of Bacteroides fragilis spondylodiscitis (BFS) secondary to percutaneous epidural adhesiolysis in a 38-year-old woman without predisposing factors.. Most cases of BFS result from hematogenous spread from a perianal abscess or sigmoidoscopy or local spread from an adjacent infection. However, BFS due to direct inoculation after percutaneous epidural adhesiolysis has not been previously reported.. A 38-year-old woman presented with spondylodiscitis at the L4-L5 level 2 weeks after percutaneous epidural adhesiolysis. Despite empirical antibiotherapy, the spondylodiscitis and an epidural abscess became much aggravated. Open biopsy and curettage was performed, and metronidazole sensitive Bacteroides fragilis was identified by tissue culture.. Metronidazole was administrated for 5 weeks and symptoms were completely resolved. Follow-up magnetic resonance imaging showed that the spondylodiscitis was completely cured.. This is the first report to be issued regarding BFS secondary to percutaneous epidural adhesiolysis. In our case, the pathogenesis may have been direct inoculation of Bacteroides fragilis into the epidural space and disc during percutaneous epidural adhesiolysis because the procedural approach used was adjacent to the anus.

Topics: Adult; Anti-Bacterial Agents; Bacteroides fragilis; Bacteroides Infections; Ceftazidime; Combined Modality Therapy; Curettage; Discitis; Epidural Abscess; Female; Humans; Intervertebral Disc Degeneration; Low Back Pain; Lumbar Vertebrae; Lumbosacral Region; Magnetic Resonance Imaging; Metronidazole; Netilmicin; Osteomyelitis; Peripheral Nervous System Diseases; Surgical Wound Infection; Tissue Adhesions

Septic osteomyelitis of the hip in a previously healthy child is described. A weakly toxigenic Corynebacterium diphtheriae strain was isolated from the bone aspirate. The results of the treatment were rapidly satisfactory, after surgical drainage and antibiotic therapy with pristinamycin.. This case report shows that C. diphtheriae has not disappeared in the developed world and can be responsible of systemic infections.

Topics: Child, Preschool; Corynebacterium diphtheriae; Corynebacterium Infections; Drug Therapy, Combination; Gait; Hip Joint; Humans; Male; Netilmicin; Osteomyelitis; Virginiamycin

A 53-year-old woman was admitted because of a two weeks' history of progressive perineal pain, low-grade fever, a high erythrocyte sedimentation rate, and tenderness over the inferior rami of the pubic bone. Osteomyelitis was suspected. However, bone scanning, computed tomography, and magnetic resonance imaging of the pelvis showed no evidence of intraosseous disease, but revealed signs of inflammation in the surrounding soft tissue. Conventional antimicrobial therapy was unsuccessful. Biopsy of the bone demonstrated active osteomyelitis and the cultures grew Pseudomonas aeruginosa. Osteomyelitis of the pubic bone and symphysis is most often a sequel to pelvic surgery but has also been observed in i.v. drug abusers. In both circumstances Pseudomonas aeruginosa has frequently been identified as the causative agent. Pelvic osteomyelitis is extremely rare in patients without predisposing factors. Osteomyelitis can only be differentiated from osteitis pubis, a non-infectious inflammatory disease, by bone biopsy. The treatment of choice for osteomyelitis is a beta-lactam antibiotic effective against pseudomonas in combination with an aminoglycoside for 4-6 weeks. Recent studies have demonstrated that new generation quinolones are also effective.

Topics: Ceftazidime; Drug Therapy, Combination; Female; Humans; Middle Aged; Netilmicin; Osteomyelitis; Pseudomonas aeruginosa; Pseudomonas Infections; Pubic Bone; Radiography

Twenty-one patients with osteomyelitis were treated with surgical debridement and local antibiotic therapy. Amikacin (19 patients) or netilmicin (2 patients) was delivered locally via a pump implanted subcutaneously. The outflow catheters were led from the pump subcutaneously to the infected area and placed in the defect created by the surgical debridement. The pump was refilled at intervals, on an outpatient basis. The pump was surgically removed at the conclusion of therapy. Follow-up evaluation was for 12-27 months. The duration of hospitalization was five to 52 days (mean, 23 days). The infusions were sustained for 32-140 days (mean, 63 days). Systemic levels of antibiotics were always below acceptable trough levels. Levels in the wound drainage of the 11 patients who drained after operation were always greater than the upper limit of the assay. Nephrotoxicity and ototoxicity were determined using pre- and posttherapy creatinine clearances and audiograms. Two patients exhibited minimal nephrotoxicity (creatinine clearance of 66 ml/minute and 55 ml/minute; normal, 70 ml/minute). There were no other adverse effects of the antibiotics. Sixteen patients have not drained since removal of the pumps.

Topics: Adult; Amikacin; Combined Modality Therapy; Debridement; Follow-Up Studies; Humans; Infusion Pumps; Middle Aged; Netilmicin; Osteomyelitis

We measured the stability of vancomycin, amikacin, netilmicin, tobramycin, gentamicin, clindamycin, and aztreonam in an implantable drug pump. Two pumps were filled with the antibiotic being tested and were incubated at 37 degrees for 3 weeks. Samples were taken daily. At 3 weeks the pumps were disassembled and examined microscopically for signs of deterioration. If the pumps were intact, bioassays were used to quantitate the biologic activity of each daily antibiotic sample. Vancomycin degraded the pump. Amikacin, netilmicin, tobramycin, gentamicin, clindamycin, and aztreonam had no effect on the pump and maintained their biologic activity over the 3-week period.

Topics: Amikacin; Anti-Bacterial Agents; Aztreonam; Clindamycin; Drug Stability; Gentamicins; Humans; Infusion Pumps; Microbial Sensitivity Tests; Netilmicin; Osteomyelitis; Tobramycin

The author has tested the action of antibiotic-loaded plaster of Paris loaded pellets in 15 patients with success in 13. Previous studies using plaster of Paris for filling bone defects are noted, plaster being well tolerated and absorbable. Gentamycin, Fucidin and Cefazolin were tested first. In a second series, Netilmicin, Amikacin, Rifamycin and Rifampicin were also used. The preparation of the pellets is fully described. In most instances they can be sterilized by gamma rays except for Fucidin and Cefazolin. Several hundred pellets can be used simultaneously. A study of the elimination of antibiotic in the urine was made. It was concluded that the concentrations obtained by this method in the tissues were highly satisfactory.

Topics: Amikacin; Anti-Bacterial Agents; Bone and Bones; Calcium Sulfate; Drug Implants; Humans; Kinetics; Netilmicin; Osteomyelitis; Rifampin; Rifamycins

Topics: Adolescent; Adult; Aged; Bacterial Infections; Connective Tissue Diseases; Enterobacteriaceae Infections; Female; Gentamicins; Humans; Male; Middle Aged; Netilmicin; Osteomyelitis; Urinary Tract Infections

Topics: Abdomen, Acute; Adult; Aged; Bacterial Infections; Female; Gentamicins; Humans; Male; Middle Aged; Netilmicin; Osteomyelitis; Surgical Wound Infection

Thirty neonates and infants have been treated for verified or suspected infections with a combination of netilmicin and ampicillin intravenously for 7 days. The infecting organisms were isolated in 18 patients, of whom 2 had osteomyelitis and 2 had pneumonia. In 3 cases of pneumonia and 9 cases of suspected septicaemia bacteriological cultures were negative. None of the children died, and in all but the 2 cases of osteomyelitis, therapy led to complete resolution of the signs of infection and recovery without sequelae. No adverse reactions to antibiotic therapy were recorded. Upon follow-up examinations at the age of 3 months there has been no sign of auditory impairment as assessed by Brain Stem Evoked Response. Netilmicin is thus tolerated well in neonates and infants, and when guided by serum concentrations considered to be a safe and reliable aminoglycoside.

Topics: Drug Evaluation; Enterobacteriaceae Infections; Female; Gentamicins; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Netilmicin; Osteomyelitis; Sepsis; Staphylococcal Infections; Streptococcal Infections