zithromax and Peritonitis

Peritoneal dialysis associated infections are common and associated with high morbidity and mortality, if not treated in a timely manner.

Topics: Amikacin; Anti-Bacterial Agents; Azithromycin; Humans; Linezolid; Male; Middle Aged; Mycobacterium abscessus; Mycobacterium Infections, Nontuberculous; Peritoneal Dialysis; Peritonitis

Topics: Abdominal Pain; Amoxicillin-Potassium Clavulanate Combination; Azithromycin; Chlamydia Infections; Chlamydia trachomatis; Female; Hepatitis; Humans; Pelvic Inflammatory Disease; Peritonitis; Tomography, X-Ray Computed; Young Adult

Topics: Adult; Anti-Bacterial Agents; Azithromycin; Chlamydia Infections; Chlamydia trachomatis; Female; Hepatitis; Humans; Liver; Pelvic Inflammatory Disease; Peritonitis; Tomography, X-Ray Computed

Topics: Abdomen; Adult; Azithromycin; Cephalosporins; Chlamydia Infections; Female; Hepatitis; Humans; Liver; Pelvic Inflammatory Disease; Peritonitis; Young Adult

A 33-year-old Caucasian man with end-stage renal disease secondary to biopsy-proven IgA nephropathy, managed with continuous ambulatory peritoneal dialysis (PD), presented with PD-related peritonitis, the causal organism being a non-branching Gram-positive bacillus, Rhodococcus equi. Initial empirical Gram positive and negative coverage with cefazolin and ceftazidime was unsuccessful, but following isolation of the organism, and conversion to intraperitoneal vancomycin and oral ciprofloxacin, the peritonitis episode resolved. At day 10, vancomycin was switched to azithromycin for a total of 6 weeks of antimicrobial therapy. The PD catheter was preserved, and the patient remained peritonitis-free at 6 months of follow-up.

Topics: Actinomycetales Infections; Adult; Anti-Infective Agents; Australia; Azithromycin; Ciprofloxacin; Drug Therapy, Combination; Follow-Up Studies; Humans; Kidney Failure, Chronic; Male; Peritoneal Dialysis, Continuous Ambulatory; Peritonitis; Rhodococcus equi; Treatment Outcome; Vancomycin

Fitz-Hugh-Curtis syndrome is an inflammation of the liver capsule as a complication of pelvic inflammatory disease, whose etiologic agent is the most common C. trachomatis. The acute phase Fitz-Hugh-Curtis syndrome may present with pain in upper right quadrant abdomen, commonly confused with other diseases of the hepatobiliary and gastrointestinal tract. Definitive diagnosis is now possible for non-invasive techniques such as ultrasound, computed tomography, as well as techniques for the isolation of the germ responsible available in most centers.

Topics: Abdominal Pain; Adult; Anti-Bacterial Agents; Azithromycin; Blood Cell Count; Chlamydia Infections; Chlamydia trachomatis; Female; Hepatitis; Hepatitis A; Humans; Pelvic Inflammatory Disease; Peritonitis; Tomography, X-Ray Computed

Antibiotic treatment of Staphylococcus aureus infections is often problematic due to the slow response to therapy and the high frequency of infection recurrence. The intracellular persistence of staphylococci has been recognized and could offer a good explanation for these treatment difficulties. Knowledge of the interplay between intracellular antibiotic activity and the overall outcome of infection is therefore important. Several intracellular in vitro models have been developed, but few experimental animal models have been published. The mouse peritonitis/sepsis model was used as the basic in vivo model exploring a quantitative ex vivo extra- and intracellular differentiation assay. The intracellular presence of S. aureus was documented by electron microscopy. Five antibiotics, dicloxacillin, cefuroxime, gentamicin, azithromycin, and rifampin (rifampicin), were tested in the new in vivo model; and the model was able to distinguish between their extra- and intracellular effects. The intracellular effects of the five antibiotics could be ranked as follows as the mean change in the log(10) number of CFU/ml (Delta log(10) CFU/ml) between treated and untreated mice after 4 h of treatment: dicloxacillin (3.70 Delta log(10) CFU/ml) > cefuroxime (3.56 Delta log(10) CFU/ml) > rifampin (1.86 Delta log(10) CFU/ml) > gentamicin (0.61 Delta log(10) CFU/ml) > azithromycin (0.21 Delta log(10) CFU/ml). We could also show that the important factors during testing of intracellular activity in vivo are the size, number, and frequency of doses; the time of exposure; and the timing between the start of infection and treatment. A poor correlation between the intracellular accumulation of the antibiotics and the actual intracellular effect was found. This stresses the importance of performing experimental studies, like those with the new in vivo model described here, to measure actual intracellular activity instead of making predictions based on cellular pharmacokinetic and MICs.

Topics: Animals; Animals, Outbred Strains; Anti-Bacterial Agents; Colony Count, Microbial; Dicloxacillin; Dose-Response Relationship, Drug; Female; Humans; Mice; Microbial Sensitivity Tests; Peritoneum; Peritonitis; Rifampin; Sepsis; Staphylococcal Infections; Staphylococcus aureus; Treatment Outcome

BB-81384, a novel peptide deformylase (PDF) inhibitor, was characterized in terms of enzyme inhibition profile, antibacterial activity, rodent pharmacokinetics and oral efficacy in murine infection models.. MICs were determined by standard NCCLS broth microdilution. Selectivity of metalloenzyme inhibition was determined with a limited panel of enzymes via standard biochemical assays. Profiling of the pharmacokinetics and select tissue disposition in mice was determined and compared with that of the macrolide, azithromycin. In vivo murine efficacy studies using Streptococcus pneumoniae were conducted using a peritonitis model, as well as lung and thigh burden models of infection.. BB-81384 selectively inhibited PDF with an IC(50) approximately 10 nM and with MICs < 0.5 mg/L against most S. pneumoniae pathogens. Pharmacokinetic analysis revealed good oral bioavailability and moderate clearance and volume of distribution. BB-81384 partitioning to lung tissue was similar in terms of magnitude and kinetics to that of the plasma compartment. Single-administration oral efficacy in a mouse peritonitis model was evident with an ED(50) of 30 mg/kg. BB-81384 reduced the bacterial load by approximately 5 and 3 log units in organ-burden models of lung and thigh infection, respectively.. BB-81384, a novel PDF inhibitor with good activity against S. pneumoniae in vitro, was the first compound of this class to be profiled for oral pharmacokinetics and tissue disposition and to demonstrate oral anti-pneumococcal efficacy in mice.

Topics: Amidohydrolases; Amoxicillin-Potassium Clavulanate Combination; Animals; Anti-Bacterial Agents; Azithromycin; Bacteria; Drug Therapy, Combination; Enzyme Inhibitors; Kinetics; Mice; Mice, Inbred ICR; Microbial Sensitivity Tests; Muscle, Skeletal; Muscular Diseases; Neutropenia; Peritonitis; Piperazines; Pneumococcal Infections; Pneumonia; Streptococcus pneumoniae; Tissue Distribution

In this study, we determined the efficacy of various dosing regimens for erythromycin and azithromycin against four pneumococci with different susceptibilities to penicillin in an in vitro pharmacokinetic model and in a mouse peritonitis model. The MIC was 0.03 microg/ml, and the 50% effective doses (determined after one dose) of both drugs were comparable for the four pneumococcal strains and were in the range of 1.83 to 6.22 mg/kg. Dosing experiments with mice, using regimens for azithromycin of one to eight doses/6 h, showed the one-dose regimen to give the best result; of the pharmacodynamic parameters tested (the maximum drug concentration in serum [Cmax], the times that the drug concentration in serum remained above the MIC and above the concentration required for maximum killing, and the area under the concentration time curve), Cmax was the best predictor of outcome. The bacterial counts in mouse blood or peritoneal fluid during the first 24 h after challenge were not correlated to survival of the mice. The serum concentration profiles obtained with mice for the different dosing regimens were simulated in the in vitro pharmacokinetic model. Here as well, the one-dose regimen of azithromycin showed the best result. However, the killing curves in vivo in mouse blood and peritoneal fluid and in the vitro pharmacokinetic model were not similar. The in vitro killing curves showed a decrease of 2 log10 within 2 and 3 h for azithromycin and erythromycin, respectively whereas the in vivo killing curves showed a bacteriostatic effect for both drugs. It is concluded that the results in terms of predictive pharmacodynamic parameters are comparable for the in vitro and in vivo models and that high initial concentrations of azithromycin favor a good outcome.

Topics: Animals; Anti-Bacterial Agents; Azithromycin; Disease Models, Animal; Erythromycin; Female; Mice; Peritonitis; Pneumonia, Pneumococcal; Streptococcus pneumoniae

Topics: Actinomycetales Infections; Aged; Anti-Bacterial Agents; Azithromycin; Humans; Male; Peritoneal Dialysis, Continuous Ambulatory; Peritonitis; Rhodococcus equi

Doses of 200 mg of azithromycin per kg (body weight) administered by the oral route daily for 10 days completely protected mice against death caused by intraperitoneal infection with Toxoplasma gondii. The same treatment regimen also protected 80% of mice infected intracerebrally, which suggests that azithromycin attains active concentrations in the inflamed central nervous system.

Topics: Animals; Azithromycin; Brain Diseases; Erythromycin; Mice; Peritonitis; Toxoplasmosis, Animal