ro13-9904 and Lung-Neoplasms

Legionella species are a common cause of community-acquired pneumonia, infrequently complicated by cavitary disease. We describe Legionella pneumophila pneumonia and abscess formation in an immunosuppressed patient receiving corticosteroid therapy for metastatic breast carcinoma. The predisposing role of corticosteroids is discussed and the management of this complication is reviewed.

Topics: Adult; Anti-Bacterial Agents; Antineoplastic Combined Chemotherapy Protocols; Australia; Azithromycin; Brain Neoplasms; Breast Neoplasms; Ceftriaxone; Combined Modality Therapy; Cranial Irradiation; Dexamethasone; Diagnosis, Differential; Drainage; Female; Humans; Immunocompromised Host; Legionella pneumophila; Legionnaires' Disease; Lung Abscess; Lung Neoplasms; Metronidazole; Roxithromycin; Thoracic Surgery, Video-Assisted; Thoracostomy; Tomography, X-Ray Computed

The efficacy of preoperative antibiotic prophylaxis in thoracic surgery with a single dose of ceftriaxone was investigated. Here we report the results of a prospective study including 192 patients undergoing thoracic surgery for non small cell lung cancer. Overall, the postoperative infection rate, as measured by wound, respiratory tract, and urinary tract infections, was 8.3% (16/192). Ceftriaxone was well tolerated, and no allergic or other adverse reactions were reported. A single preoperative dose of ceftriaxone was cost-effective and allowed considerable saving of time, material, labor costs and money. This study, even though open and non-comparative, suggests that the routine use of a single preoperative dose of ceftriaxone provides a cost-effective prophylaxis for patients undergoing major thoracic operations.

Topics: Adult; Aged; Antibiotic Prophylaxis; Carcinoma, Non-Small-Cell Lung; Ceftriaxone; Cephalosporins; Female; Humans; Injections, Intravenous; Lung Neoplasms; Male; Middle Aged; Postoperative Complications; Prospective Studies; Pulmonary Surgical Procedures; Respiratory Tract Infections; Surgical Wound Infection; Urinary Tract Infections

Ceftriaxone, an FDA-approved third-generation cephalosporin antibiotic, has antimicrobial activity against both gram-positive and gram-negative organisms. Generally, ceftriaxone is used for a variety of infections such as community-acquired pneumonia, meningitis and gonorrhea. Its primary molecular targets are the penicillin-binding proteins. However, other activities of ceftriaxone remain unknown. Herein, we report for the first time that ceftriaxone has antitumor activity in vitro and in vivo. Kinase profiling results predicted that Aurora B might be a potential 'off' target of ceftriaxone. Pull-down assay data confirmed that ceftriaxone could bind with Aurora B in vitro and in A549 cells. Furthermore, ceftriaxone (500 µM) suppressed anchorage-independent cell growth by targeting Aurora B in A549, H520 and H1650 lung cancer cells. Importantly, in vivo xenograft animal model results showed that ceftriaxone effectively suppressed A549 and H520 lung tumor growth by inhibiting Aurora B. These data suggest the anticancer efficacy of ceftriaxone for the treatment of lung cancers through its inhibition of Aurora B.

Topics: Animals; Anti-Bacterial Agents; Aurora Kinase B; Aurora Kinases; Ceftriaxone; Cell Line, Tumor; Epidermal Growth Factor; Humans; Lung Neoplasms; Mice; Protein Serine-Threonine Kinases

Topics: Aged; Anti-Bacterial Agents; Antineoplastic Combined Chemotherapy Protocols; Brain Neoplasms; Carcinoma, Small Cell; Ceftriaxone; Cisplatin; Combined Modality Therapy; Cranial Irradiation; Etoposide; Fatal Outcome; Female; Humans; Immunocompromised Host; Lung Neoplasms; Opportunistic Infections; Pneumonia, Pneumocystis; Pneumonia, Staphylococcal; Staphylococcus aureus; Trimethoprim, Sulfamethoxazole Drug Combination

A 62-year-old man with adenocarcinoma underwent complete resection with a right upper lobectomy and en-bloc resection of the chest wall, with metallic clips applied to the vertebral nerve roots. A sudden deterioration in neurological status occurred due to pneumocephalus and ascending bacterial meningitis resulting from a subarachnoid-pleural fistula. The neurological status normalized after thoracoplasty and ceftriaxone treatment.

Topics: Adenocarcinoma; Adenocarcinoma of Lung; Anti-Bacterial Agents; Brain Diseases; Ceftriaxone; Fistula; Humans; Iatrogenic Disease; Lung Neoplasms; Male; Meningitis, Pneumococcal; Middle Aged; Pleural Diseases; Pneumocephalus; Pneumonectomy; Reoperation; Respiratory Tract Fistula; Streptococcus pneumoniae; Subarachnoid Space; Thoracoplasty; Tomography, X-Ray Computed; Treatment Outcome

A patient with painful peripheral neuropathy is presented, whose symptoms were thought to result from an infection with Borrelia burgdorferi sensu lato. Investigations of the cerebrospinal fluid for signs of inflammation and borrelial antibodies were negative, and the patient did not benefit from repeated antibiotic treatment. Electrophysiologic studies and sural nerve biopsy showed axonal neuropathy consistent with a paraneoplastic syndrome. Further workup revealed mediastinal Hodgkin's disease (HD; nodular sclerosing subtype) Ann Arbor stage II and non-small cell cancer of the lung (stage T1N0M0). Surgical resection of the lung cancer and combined chemo- and radiotherapy for HD resulted in complete remission of both malignancies. While the preexisting neurologic symptoms persisted during treatment, neurography showed some improvement of the distal nerves. During radiation therapy the patient developed transient left-sided brachial plexopathy. This case illustrates that the diagnosis of borreliosis in patients with isolated painful peripheral neuritis cannot be based solely upon positive IgG titers and supports the requirement for a thorough workup for an underlying--potentially curable--disease. In addition, singular pulmonary lesions in the setting of HD should be suspected to have a separate cause.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Biopsy; Carcinoma, Non-Small-Cell Lung; Ceftriaxone; Electrophysiology; Hodgkin Disease; Humans; Lung Neoplasms; Lyme Disease; Male; Paraneoplastic Polyneuropathy; Radiotherapy; Remission Induction; Sural Nerve; Tomography, X-Ray Computed