ro13-9904 and Necrosis

Topics: Administration, Intravenous; Ceftriaxone; Child; Female; Hand; Humans; Necrosis; Nicolau Syndrome; Skin

Necrotizing soft tissue infections are rapidly progressive infections with a high rate of mortality. One type of necrotizing soft tissue infection is caused by marine gram-negative bacteria and commonly occurs in immunocompromised hosts. These types of infections are more common in patients with chronic liver disease, possibly because of impaired iron metabolism. We present the case of a rapidly progressive necrotizing soft tissue infection caused by Edwardsiella tarda, a marine gram-negative pathogen common in catfish. Few extraintestinal infections of E tarda have been described previously. Our patient had hepatitis C and was exposed to the bacteria by a puncture injury from a wild catfish. His infection required multiple debridements and ultimately required a transhumeral amputation for local control of the infection.

Topics: Amputation, Surgical; Animals; Anti-Bacterial Agents; Catfishes; Ceftriaxone; Comorbidity; Debridement; Disease Progression; Edwardsiella tarda; Enterobacteriaceae Infections; Fascia; Hand Injuries; Hepatitis C; Humans; Male; Middle Aged; Muscle, Skeletal; Necrosis; Soft Tissue Infections; Upper Extremity; Wounds, Penetrating

To assess the usefulness of postoperative clarithromycin versus classical postoperative prophylaxis with occlusive dressing to prevent cochlear implant skin flap complications.. Cohort study.. Surgical site infections were compared in four groups: 1) ceramic/classical postoperative cares (21 patients), 2) titanium-silicon/classical postoperative cares (75), 3) ceramic/clarithromycin (24), and 4) titanium-silicon/clarithromycin (76). Preoperative ceftriaxone was systematically used in all patients in all four groups. Patients were followed up for at least 4 months. Attributable risk and number needed to treat were calculated.. All infections appeared in titanium-silicon covered implants, and the risk of surgical site infection was 8.1 times higher in patients treated only with ceftriaxone and classical postoperative prophylaxis compared to those also given clarithromycin. Eleven patients needed to receive clarithromycin to avoid surgical infection.. Long-term treatment with low-dose clarithromycin may reduce the incidence of surgical site infections.

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Antibiotic Prophylaxis; Ceftriaxone; Child; Child, Preschool; Clarithromycin; Cochlear Implantation; Cochlear Implants; Female; Humans; Infant; Male; Middle Aged; Necrosis; Occlusive Dressings; Prosthesis Design; Surgical Flaps; Surgical Wound Infection; Young Adult

Topics: Adolescent; Anti-Bacterial Agents; Ceftriaxone; Cholecystectomy, Laparoscopic; Cholecystitis, Acute; Cholelithiasis; Humans; Male; Necrosis

Infected pancreatic necrosis was diagnosed clinically and radiologically in a patient admitted for acute pancreatitis. As free gas in the pancreatic area was recognized, antibiotic therapy (ceftriaxone) was empirically introduced, while surgical drainage was being planned. After the second week, the patient rapidly started to improve, to the point that he could be discharged home without operation. Control CT-scans and general laboratory tests, at this phase and later on, confirmed a still enlarged gland but free of infection or ongoing inflammation. Cholelithiasis, which had been identified in an early ultrasound scan, was electively treated by cholecystectomy 2 mo after the onset of pancreatitis, in the absence of sepsis, and with uneventful recovery. This case illustrates the rare possibility of spontaneous regression of infected necrotic pancreatitis, without any type of operation or nonoperative drainage.

Topics: Acute Disease; Aged; Bacterial Infections; Ceftriaxone; Humans; Male; Necrosis; Pancreas; Pancreatitis; Remission, Spontaneous; Tomography, X-Ray Computed

Having affirmed that a dose of 2 g ceftriaxone (CTRX) administered subcutaneously (SC) to healthy volunteers was well absorbed, the same dose administered to eight patients first intravenously (days 1 to 3), then SC (days 4 to 6). Plasma levels obtained after SC administration are similar to those obtained after IV administration and are consistent with drug therapeutic efficacy. The poor tolerance of CTRX when administered SC represents a very important limiting factor on the administration of a 2 g dose via this path.

Topics: Adult; Aged; Aged, 80 and over; Ceftriaxone; Drug Tolerance; Female; Humans; Injections, Subcutaneous; Male; Middle Aged; Necrosis; Pain