ro13-9904 and Skin-Ulcer

Ceftriaxone is generally recognized to be safe and effective when administered either intravenously or intramuscularly to both adults and children as a single drug for skin and skin structure infections. An advantage of ceftriaxone over the other third-generation cephalosporins is its long serum half-life, which allows it to be given every 12 hours in children and every 24 hours in most adults. There is no question that ceftriaxone is effective for skin and soft tissue infections, particularly those caused by staphylococci and streptococci. The drug's sales to home infusion companies around the country attest to its widespread use for such infections. The fact remains, however, that the data required to substantiate efficacy and safety for ceftriaxone or for any of the other third-generation cephalosporins are just not available in large numbers.

Topics: Adult; Bacterial Infections; Ceftriaxone; Cellulitis; Child; Humans; Infant; Skin Diseases, Infectious; Skin Ulcer

Topics: Anti-Bacterial Agents; Ceftriaxone; Critical Care; Debridement; Humans; Male; Metronidazole; Middle Aged; Skin Ulcer; Tetanus; Tetanus Toxoid

Topics: Aged, 80 and over; Anti-Bacterial Agents; Ceftriaxone; Female; Hemagglutination Tests; Humans; Skin Ulcer; Syphilis, Cutaneous; Treponema pallidum

Invasive group A streptococcal (GAS) strains often have genetic differences compared to GAS strains from nonsterile sites. Invasive, "hypervirulent" GAS strains can arise from a noninvasive progenitor following subcutaneous inoculation in mice, but such emergence has been rarely characterized in humans. We used whole genome analyses of multiple GAS isolates from the same patient to document the molecular basis for emergence of a GAS strain with an invasive phenotype during human infection. In contrast to previous theories, we found that elimination of production of the cysteine protease SpeB was not necessary for emergence of GAS with an invasive, "hypervirulent" phenotype.

Topics: Aged; Anti-Bacterial Agents; Ceftriaxone; Genetic Variation; Humans; Male; Sepsis; Skin Ulcer; Streptococcal Infections; Streptococcus pyogenes