nystatin-a1 and Pseudomonas-Infections

A double-blind, randomised clinical trial was conducted in Queensland general practices to evaluate the efficacy of oral doses of trimethoprim-sulfamethoxazole (cotrimoxazole) as an adjunct to Kenacomb ointment in the treatment of acute diffuse otitis externa.. One hundred and five patients with otitis externa agreed to enter the trial; 13 of these had bilateral otitis externa. Six symptoms and signs of otitis externa were rated on a scale of 1 (none) to 5 (severe) and then the scores were averaged to give an index of severity. Swabs from all infected ears were cultured and then the patients were treated with Kenacomb ointment. Patients were randomly assigned to take a five-day course of either oral cotrimoxazole or an oral placebo and were reassessed on Days 2-4 and Days 5-6 after presentation.. The mean duration (+/- standard deviation) of ear pain from the first visit for the cotrimoxazole and placebo groups was 3.1 (+/- 1.5) days and 3.1 (+/- 1.7) days respectively. The mean severity indices (+/- standard deviation) for these groups on presentation were 2.33 (+/- 0.59) and 2.37 (+/- 0.57). The respective reductions in these scores by the second visit were 0.72 and 0.69 and by the third visit 1.10 and 1.05. The principle pathogen isolated was Pseudomonas aeruginosa.. This suggests that oral cotrimoxazole is unlikely to be useful as an adjunct to Kenacomb ointment in the treatment of mild to moderate otitis externa.

Topics: Administration, Oral; Adult; Child; Double-Blind Method; Drug Combinations; Earache; Female; Gramicidin; Humans; Male; Neomycin; Nystatin; Otitis Externa; Placebos; Pseudomonas aeruginosa; Pseudomonas Infections; Staphylococcal Infections; Tablets; Triamcinolone Acetonide; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Gentamicins; Hemorrhage; Humans; Infection Control; Leukemia, Myeloid, Acute; Middle Aged; Nystatin; Patient Isolators; Prospective Studies; Pseudomonas Infections; Remission, Spontaneous; Respiratory Tract Infections; Vancomycin

Pseudomonas aeruginosa infection is a serious complication in patients with cystic fibrosis and in immunocompromised individuals. Here we show that P. aeruginosa infection triggers activation of the acid sphingomyelinase and the release of ceramide in sphingolipid-rich rafts. Ceramide reorganizes these rafts into larger signaling platforms that are required to internalize P. aeruginosa, induce apoptosis and regulate the cytokine response in infected cells. Failure to generate ceramide-enriched membrane platforms in infected cells results in an unabated inflammatory response, massive release of interleukin (IL)-1 and septic death of mice. Our findings show that ceramide-enriched membrane platforms are central to the host defense against this potentially lethal pathogen.

Topics: Animals; Apoptosis; beta-Cyclodextrins; Bone Marrow Transplantation; Cells, Cultured; Ceramides; Cyclodextrins; Cystic Fibrosis Transmembrane Conductance Regulator; Enzyme Activation; Epithelial Cells; fas Receptor; Fibroblasts; Filipin; Fluorescent Dyes; Humans; Ionophores; Membrane Microdomains; Mice; Nystatin; Pseudomonas aeruginosa; Pseudomonas Infections; Signal Transduction; Sphingomyelin Phosphodiesterase

Topics: Anuria; Candida albicans; Candidiasis; Gentamicins; Gestational Age; Humans; Infant; Infant, Newborn; Male; Nystatin; Pseudomonas Infections; Urinary Catheterization; Urinary Tract Infections

Topics: Candidiasis, Cutaneous; Diagnosis, Differential; Humans; Nails; Nystatin; Onychomycosis; Paronychia; Pseudomonas Infections; Psoriasis; Staphylococcal Infections; Streptococcal Infections