nystatin-a1 and Acute-Disease

Several prospectively randomized trials have shown that the administration of prophylactic oral nonabsorbable antibiotics may be beneficial in decreasing the incidence of infection in granulocytopenic patients, whereas others have not. Intolerable nausea and vomiting have prevented the prolonged use of these agents in some studies. Discontinuation of therapy while patients are still granulocytopenic has carried the risk of life-threatening infections, often with aminoglycoside-resistant gram-negative organisms. The benefit of selective decontamination with trimethoprim/sulfamethoxazole used prophylactically remains controversial. The use of trimethoprim/sulfamethoxazole may also be associated with the development of resistant, potentially pathogenic, organisms or prolonged neutropenia. These regimens do not appear to be indicated when patients are anticipated to be neutropenic for less than three weeks. Even in patients with prolonged neutropenia, the risks of such treatment must be weighed against potential benefits.

Topics: Acute Disease; Agranulocytosis; Anti-Bacterial Agents; Bacterial Infections; Clinical Trials as Topic; Colistin; Drug Combinations; Environment, Controlled; Gentamicins; Humans; Leukemia; Neoplasms; Nystatin; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination; Vancomycin

Acute otitis externa is a common clinical condition accounting for a large proportion of patients attending the otolaryngology department, although milder cases are often managed in primary care. Treatment of the most severe forms of otitis externa involves aural toilet, followed by the application of a topical preparation, commonly in the form of an ear canal dressing. A prospective single-blind randomized controlled trial was performed to compare the efficacy of 10% glycerine-ichthammol (GI) solution and Triadcortyl (TAC) ointment, both applied as ear canal dressings, in the initial management of severe acute otitis externa. A total of 64 patients were studied. Both treatment modalities were proven efficacious in the treatment of severe acute otitis externa. Although there was a statistically significant improvement of pain parameters in the TAC group, we found no significant differences in clinical findings between the two groups. Therefore, it is recommended that GI dressing can be used instead of an antibiotic dressing as an initial treatment of severe acute otitis externa on the basis of cost, avoidance of resistance and toxicity.

Topics: Acute Disease; Adolescent; Adult; Aged; Anti-Inflammatory Agents; Drug Combinations; Female; Glycerol; Gramicidin; Humans; Male; Middle Aged; Neomycin; Nystatin; Otitis Externa; Pain Measurement; Quaternary Ammonium Compounds; Solvents; Treatment Outcome; Triamcinolone Acetonide

In this multicentre, randomised, double-blind study, the safety and efficacy of oral fluconazole (200 micrograms/day) and nystatin suspension (6,000,000 IU/day) for the prevention of fungal infections were compared in patients with leukaemia undergoing remission induction chemotherapy. Antifungal prophylaxis was initiated at the time chemotherapy was started and continued throughout the hospital stay or the period of neutropenia to a maximum of 42 days. Prophylaxis was successful (no evidence of fungal infection or fever of unknown origin unresponsive to antibiotics) in 38 of 56 (68%) fluconazole-treated and 25 of 53 (47%) nystatin-treated patients (P = 0.03). 2 patients (4%) in the fluconazole group and 6 (11%) patients in the nystatin group developed systemic fungal infections (P = 0.15). The overall frequency of adverse events was similar among fluconazole-treated (29%) and nystatin-treated (32%); most events in both treatment groups involved the gastrointestinal tract. These results indicated fluconazole was more effective than nystatin in preventing Candida infections in patients with leukaemia; fluconazole was well tolerated.

Topics: Acute Disease; Administration, Oral; Adolescent; Adult; Aged; Aged, 80 and over; Antifungal Agents; Candidiasis; Double-Blind Method; Female; Fluconazole; Humans; Leukemia; Male; Middle Aged; Neutropenia; Nystatin; Opportunistic Infections; Treatment Outcome

In vitro study of the antibacterial activity of macrolide antibiotics azitromycin (sumamed), midicamycin (macropen), roxitromycin (rulide), and erythromycin demonstrated their high activity towards clinical strains of bacteroids, fusobacteria, peptostreptococci, streptococci, and corynebacteria. These antibiotics were effective in the treatment of 62 adult patients with severe and moderate generalized periodontitis. Rulide and sumamed were the most effective, macropen and erythromycin were inferior to them.

Topics: Acute Disease; Adolescent; Adult; Anti-Bacterial Agents; Antifungal Agents; Azithromycin; Chronic Disease; Drug Therapy, Combination; Erythromycin; Humans; Leucomycins; Middle Aged; Nystatin; Periodontitis; Roxithromycin

Seventy-three patients mainly receiving consolidation therapy for acute leukemia or autologous bone marrow transplantation were studied in a randomized trial comparing nystatin with norfloxacin (800 mg) given orally QID, for prevention of infection. Both groups were equally distributed in regard to age, disease, and duration of granulocytopenia, although far more patients entered the laminar air flow room in the norfloxacin group. Duration of more than a 39 degrees C fever was much longer in the nystatin group than in the norfloxacin group: Bacteremia, microbiologically documented infections, and fever of unknown origin were more frequently seen in the nystatin group, but there was no significant difference between the two groups. On the other hand, patients without fever during granulocytopenia were more numerous in the norfloxacin group than in the nystatin group (p less than 0.05). Furthermore, three deaths during granulocytopenia occurred in the nystatin group. In conclusion, prophylactic administration of norfloxacin during granulocytopenia showed a significant afebrile period.

Topics: Acute Disease; Administration, Oral; Adolescent; Adult; Bacterial Infections; Bone Marrow Transplantation; Humans; Leukemia; Middle Aged; Norfloxacin; Nystatin; Postoperative Care

Pipemidic acid (PPA) and colistin sodium methanesulfonate (CLM) may selectively suppress aerobic gram-negative bacilli. Twenty-nine patients with acute leukemia were randomized after each course of consolidation chemotherapy to receive a single agent of nystatin (NYS) (34 courses) versus a combination of NYS, PPA and CLM (36 courses). The duration of fever over 39 degrees C was longer with the three drug combination (4.6 +/- 5.1 days) than with NYS alone (1.8 +/- 1.8 days) (P less than 0.01). Four cases of pneumonia occurred and four patients including one having pneumonia died of infection with the three drug combination, while no pneumonia or death occurred with NYS alone (P = 0.06 and P = 0.06, respectively). The combination of NYS, PPA and CLM may be less effective than NYS alone for the prevention of infection in acute leukemia patients with chemotherapy-associated granulocytopenia.

Topics: Acute Disease; Adolescent; Adult; Agranulocytosis; Antineoplastic Combined Chemotherapy Protocols; Bacterial Infections; Colistin; Drug Therapy, Combination; Gram-Negative Bacteria; Humans; Leukemia; Middle Aged; Nicotinic Acids; Nystatin; Pipemidic Acid; Pneumonia; Random Allocation

A randomized trial was conducted comparing ketoconazole and nystatin in the prevention of oral candidiasis and appearance of invasive fungal infections in 51 neutropenic leukemic patients undergoing induction chemotherapy. Ketoconazole was administered in a 200 mg dose twice daily. Nystatin oral suspension was given in doses of 500,000 units four times daily. Surveillance cultures of the throat and urine were obtained prior to treatment and conducted weekly. Patients were enrolled in the study if the absolute granulocyte count was less than 1500/microliter, if physical examination revealed no evidence of oral candidiasis, no evidence of urinary tract infection, and there was no pulmonary infiltrate on chest x-ray. Patients were continued on study until the absolute granulocyte count reached 1500/microliter, evidence of oral candidiasis appeared, or presumed or proven invasive fungal infections appeared. Of the 46 evaluable patients, 22 received ketoconazole, 3 (14%) developed oral candidiasis, and 5 developed suspected systemic fungal infections (23%). Of 24 patients who received nystatin, 4 (17%) developed oral candidiasis and 8 (33%) developed systemic fungal infections, 4 proven and 4 suspected. Significantly more patients on the nystatin arm progressed to invasive fungal infections. Ketoconazole was not superior to nystatin in reducing the frequency of oral candidiasis but possibly reduced the frequency of invasive fungal infections.

Topics: Acute Disease; Adolescent; Adult; Aged; Agranulocytosis; Candidiasis, Oral; Female; Humans; Immune Tolerance; Ketoconazole; Leukemia; Male; Middle Aged; Neutropenia; Nystatin; Random Allocation

Several prospectively randomized trials have shown that the administration of prophylactic oral nonabsorbable antibiotics may be beneficial in decreasing the incidence of infection in granulocytopenic patients, whereas others have not. Intolerable nausea and vomiting have prevented the prolonged use of these agents in some studies. Discontinuation of therapy while patients are still granulocytopenic has carried the risk of life-threatening infections, often with aminoglycoside-resistant gram-negative organisms. The benefit of selective decontamination with trimethoprim/sulfamethoxazole used prophylactically remains controversial. The use of trimethoprim/sulfamethoxazole may also be associated with the development of resistant, potentially pathogenic, organisms or prolonged neutropenia. These regimens do not appear to be indicated when patients are anticipated to be neutropenic for less than three weeks. Even in patients with prolonged neutropenia, the risks of such treatment must be weighed against potential benefits.

Topics: Acute Disease; Agranulocytosis; Anti-Bacterial Agents; Bacterial Infections; Clinical Trials as Topic; Colistin; Drug Combinations; Environment, Controlled; Gentamicins; Humans; Leukemia; Neoplasms; Nystatin; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination; Vancomycin

Fifty-three profoundly granulocytopenic patients with relapsed acute leukemia who were undergoing reinduction chemotherapy were prospectively randomized to receive either trimethoprim-sulfamethoxazole plus nystatin or gentamicin plus nystatin for prevention of infections. The acquisition of new organisms per patient during the total study period was similar in both groups. Thirty-five symptomatic infections (five of which were bacteremias) occurred in patients receiving trimethoprim-sulfamethoxazole plus nystatin, whereas 31 infections (eight bacteremias) occurred in patients receiving gentamicin plus nystatin. Four deaths related to infection occurred in patients taking trimethoprim-sulfamethoxazole, and eight occurred in patients taking gentamicin. We conclude that trimethoprim-sulfamethoxazole plus nystatin was approximately as effective as gentamicin plus nystatin for prophylaxis against infection in relapsed acute leukemia. Furthermore, side effects were fewer and compliance was better with trimethoprim-sulfamethoxazole plus nystatin.

Topics: Acute Disease; Adult; Aged; Clinical Trials as Topic; Drug Combinations; Drug Therapy, Combination; Female; Gentamicins; Humans; Infection Control; Infections; Leukemia; Male; Middle Aged; Nystatin; Random Allocation; Sulfamethoxazole; Trimethoprim

113 patients being treated for acute non-lymphoblastic leukaemia were investigated to determine the effect of suppression of body microbial flora on prevention of infection. They were randomly allocated to a control group or a group which received non-absorbed antibiotics by mouth and topical applications of cutaneous and mucosal antiseptic preparations. The group receiving oral non-absorbed antibiotics had significantly few infections, fewer deaths from infection, fewer pyrexial episodes, and consequently received less systemic antibiotic therapy than the controls.

Topics: Acute Disease; Administration, Oral; Administration, Topical; Adolescent; Adult; Antineoplastic Agents; Bacterial Infections; Bacteroides Infections; Chlorhexidine; Colistin; Drug Combinations; Enterobacteriaceae Infections; Framycetin; Humans; Leukemia; Nystatin; Remission, Spontaneous; Sepsis; Staphylococcal Infections; Staphylococcus aureus; Streptococcal Infections

Reverse isolation and prophylactic oral nonabsorbable antibiotics were evaluated among 64 consecutive noninfected adults with acute nonlymphocytic leukemia admitted for remission induction. Patients were randomly allocated to laminar air flow room reverse isolation with oral nonabsorbable antibiotics (LAF plus A), routine hospital ward care with antibiotics (W plus A), or ward care alone (W). The LAF plus A patients had a significantly decreased incidence of total infection, bacteremias, pneumonias, rectal abscesses, urinary tract infection, and pharyngitis. Infectious deaths were reduced in the LAF plus A group and the time to the first infection or to fatal infection was delayed. The W plus A patients who regularly ingested the antibiotics had a reduction in infections similar to that of the LAF plus A patients but those who could not tolerate the antibiotics had an incidence of infection comparable to the ward patients. The LAF plus A and the W plus A patients also had higher complete remission rates and longer median survival than the unprotected ward patients.

Topics: Acute Disease; Administration, Oral; Adult; Aged; Air Conditioning; Air Microbiology; Anti-Bacterial Agents; Bacterial Infections; Cross Infection; Environment, Controlled; Female; Gentamicins; Hospital Units; Humans; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Male; Middle Aged; Nystatin; Patient Isolators; Remission, Spontaneous; Urinary Tract Infections; Vancomycin; Ventilation; Virus Diseases

Topics: Acute Disease; Anti-Bacterial Agents; Bacitracin; Blood Cell Count; Blood Platelets; Disinfection; Drug Combinations; Fever; Germ-Free Life; Glucose; Hexetidine; Humans; Leukemia; Neomycin; Neutropenia; Nystatin; Patient Isolators; Pneumonia; Remission, Spontaneous; Respiratory Tract Infections; Sterilization; Thrombelastography; Time Factors; Xylose

The anti-inflammatory effect of Arnica montana 6cH was evaluated using acute and chronic inflammation models. In the acute, model, carrageenin-induced rat paw oedema, the group treated with Arnica montana 6cH showed 30% inhibition compared to control (P < 0.05). Treatment with Arnica 6cH, 30 min prior to carrageenin, did not produce any inhibition of the inflammatory process. In the chronic model, Nystatin-induced oedema, the group treated 3 days previously with Arnica montana 6cH had reduced inflammation 6 h after the inflammatory agent was applied (P < 0.05). When treatment was given 6 h after Nystatin treatment, there was no significant inhibitory effect. In a model based on histamine-induced increase of vascular permeability, pretreatment with Arnica montana 6cH blocked the action of histamine in increasing vascular permeability.

Topics: Acute Disease; Analysis of Variance; Animals; Anti-Inflammatory Agents; Arnica; Carrageenan; Chronic Disease; Disease Models, Animal; Dose-Response Relationship, Drug; Edema; Foot Diseases; Granulation Tissue; Inflammation; Male; Nystatin; Phytotherapy; Plant Extracts; Random Allocation; Rats; Rats, Wistar; Time Factors

We report three cases of acute generalized exanthematous pustulosis (AGEP) following oral administration of nystatin. All cases showed similar clinical features and histopathological findings, and a delayed-type hypersensitivity to nystatin could be demonstrated in patch and prick testing. Drug eruptions to nystatin are extremely rare, and, to our knowledge. AGEP has not been reported previously.

Topics: Acute Disease; Adult; Antifungal Agents; Drug Eruptions; Exanthema; Female; Humans; Middle Aged; Nystatin

For prevention of infection we used an SD design including antibacterial (trimethoprim 480 mg/daily, sulfamerazine 720 mg/daily, and polymyxin 0.25 mg/daily) and antifungal (4-6 million IU nystatin/daily) components. We analyzed retrospectively 138 treatment periods in 108 patients. The intensified chemotherapy resulted in severe granulocytopenia below 0.1 x 10(9)/liter over 25.2 days. In 19 patients there was suspicion of major fungal infection; therefore they were given amphotericin B and 5-fluocytosine. Fourteen of them died; major fungal infections were documented in 5 cases. In 18% of all the deceased we found major fungal infections. There was a correlation between fungal infection, the late stages of the hematological malignancy, and the lesions on the oropharyngeal mucosa. However, in terms of the serological and culture findings no correlation appeared to exist between the group with and the group without fungal infection. The SD regime is meant to suppress the Candida cell concentration in the digestive tract but has no influence on Aspergillus in the respiratory tract.

Topics: Acute Disease; Adolescent; Adult; Aged; Bacterial Infections; Digestive System; Drug Administration Schedule; Drug Therapy, Combination; Female; Humans; Leukemia; Male; Middle Aged; Mycoses; Nystatin; Opportunistic Infections; Polymyxins; Sulfamerazine; Trimethoprim

Topics: Acute Disease; Administration, Oral; Anemia, Aplastic; Bacterial Infections; Bone Marrow Transplantation; Drug Therapy, Combination; Humans; Intestines; Leukemia; Nystatin; Premedication; Tobramycin; Vancomycin

Topics: Acute Disease; Bacterial Infections; Colistin; Drug Evaluation; Drug Therapy, Combination; Framycetin; Humans; Leukemia; Neomycin; Nystatin; Patient Isolation

During a 20-month period all acute nonlymphocytic patients (87 patient trials) receiving cytotoxic chemotherapy were placed on an oral nonabsorbable antibiotic regimen consisting of gentamicin, vancomycin, and nystatin in addition to an intensive program of infection prevention aimed at reducing exogenously acquired and body-surface potential pathogens. Although side effects of anorexia, diarrhea, and nausea were common, gentamicin-vancomycin-nystatin was ingested 80% of the study time. Microbial growth in gingival and rectal cultures was substantially reduced. The incidence of bacteremias and other serious infections was low. Pseudomonas aeruginosa, other gram-negative bacilli, and Candida species caused few infections along the alimentary canal, whereas infections of the skin (especially Staphylococcus aureus) were not reduced compared with those occurring in former years. A total of the 104 acquired gram-negative bacilli were gentamicin resistant; 5 subsequently caused infection. Thus, despite certain definite drawbacks, the use of oral nonabsorbable antibiotics to suppress alimentary tract microbial flora in combination with other infection prevention techniques in granulocytopenic cancer patients has proven feasible and tolerable and has been associated with a low order of life-threatening infections.

Topics: Acute Disease; Administration, Oral; Adolescent; Adult; Aged; Agranulocytosis; Anti-Bacterial Agents; Drug Resistance, Microbial; Drug Therapy, Combination; Gentamicins; Humans; Infection Control; Infections; Leukemia; Middle Aged; Nystatin; Vancomycin

Topics: Acute Disease; Administration, Oral; Agranulocytosis; Evaluation Studies as Topic; Humans; Infection Control; Kanamycin; Leukemia; Neutropenia; Nystatin; Patient Isolators; Polymyxins; Radiation Injuries; Ristocetin

A carefully controlled comparative study showed miconazole nitrate 2% vaginal cream (Monistat) to be a highly effective agent in the treatment of vaginal candidiasis in pregnant subjects. Miconazole nitrate was significantly more effective than nystatin (Mycostatin) in the treatment of vaginal candidiasis in all three trimesters of pregnancy, and also more effective regardless of whether the candidal infection was primary or recurrent. Observations relating to the safety of this therapy during pregnancy were made and discussed.

Topics: Acute Disease; Candidiasis, Vulvovaginal; Female; Fetus; Humans; Imidazoles; Infant, Newborn; Male; Miconazole; Nystatin; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Trimester, First; Pregnancy Trimester, Second; Pregnancy Trimester, Third; Recurrence

Topics: Acute Disease; Aminophylline; Anti-Bacterial Agents; Blood Coagulation; Body Temperature; Chronic Disease; Erythromycin; Furosemide; Heparin; Humans; Nikethamide; Nystatin; Oleandomycin; Penicillins; Peptide Hydrolases; Physical Therapy Modalities; Plasma Substitutes; Pneumonia; Pneumonia, Staphylococcal; Streptomycin; Strophanthins; Sulfadimethoxine; Sulfanilamides; Tetracycline; Vitamins

Topics: Acute Disease; Adolescent; Adult; Aged; Chronic Disease; Drug Combinations; Female; Gramicidin; Humans; Hypersensitivity; Male; Middle Aged; Neomycin; Nystatin; Ointments; Skin Diseases; Triamcinolone Acetonide

Topics: Acute Disease; Administration, Oral; Adolescent; Adult; Aged; Agranulocytosis; Anti-Bacterial Agents; Bacterial Infections; Feces; Female; Gentamicins; Humans; Leukemia; Male; Middle Aged; Mycoses; Neutrophils; Nystatin; Remission, Spontaneous; Vancomycin

Topics: Acute Disease; Agranulocytosis; Anti-Bacterial Agents; Antineoplastic Agents; Bacitracin; Bacteriological Techniques; Diet Therapy; Dietetics; Digestive System; Drug Synergism; Feces; Gastroenteritis; Gentamicins; Humans; Infection Control; Infections; Leukemia; Leukocyte Count; Neomycin; Nystatin; Polymyxins; Sterilization

Topics: Acute Disease; Candida; Chronic Disease; Humans; Nystatin; Paronychia

Topics: Acute Disease; Adolescent; Adult; Aged; Anti-Bacterial Agents; Antineoplastic Agents; Arachnoiditis; Brain Abscess; Child; Child, Preschool; Chronic Disease; Female; Humans; Infant; Male; Meningitis; Middle Aged; Nystatin; Osteomyelitis; Polysaccharides, Bacterial; Serratia marcescens; Spinal Cord Diseases; Streptomycin

Topics: Acute Disease; Adult; Aged; Candidiasis, Oral; Chronic Disease; Female; Gentian Violet; Humans; Male; Middle Aged; Nystatin; Retrospective Studies

Topics: Acute Disease; Anti-Bacterial Agents; Humans; Nystatin; Protein Synthesis Inhibitors; Tetracycline; Urinary Tract Infections