Epidemic Clostridium difficile-Associated Diarrhea: Role of Second- and Third-Generation Cephalosporins

1994 ◽  
Vol 15 (2) ◽  
pp. 88-94 ◽  
Author(s):  
David E. Nelson ◽  
Steven B. Auerbach ◽  
Aldona L. Baltch ◽  
Ethel Desjardin ◽  
Consuelo Beck-Sague ◽  
...  
1994 ◽  
Vol 15 (2) ◽  
pp. 88-94 ◽  
Author(s):  
David E. Nelson ◽  
Steven B. Auerbach ◽  
Aldona L. Baltch ◽  
Ethel Desjardin ◽  
Consuelo Beck-Sague ◽  
...  

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Xiao-Qin Liu ◽  
Xue-Yun Zhang ◽  
Yue Ying ◽  
Jian-Ming Zheng ◽  
Jian Sun ◽  
...  

Abstract Background Acute-on-chronic liver failure (ACLF) is characterized by an excessive systemic inflammatory response and organ failure and has high mortality. Bacterial infections (BIs) worsen the clinical course of ACLF and carry a poor prognosis in ACLF patients. The efficacy of third-generation cephalosporins has been challenged in recent years. The aim of this study was to characterize the difference between ACLF patients with and without BIs and to provide a reference for medical intervention. Methods A total of 140 patients with hepatitis B virus-related ACLF (HBV-ACLF) hospitalized at the Department of Infectious Diseases, Huashan Hospital, Fudan University (Shanghai, China) between May 2013 and January 2020 were enrolled. Mann-Whitney U test was used to compare the baseline characteristics of HBV-ACLF patients with and without BIs. Univariate and multivariate analyses were performed to find predictors of BIs. The characteristics of BIs and the role of prophylactic antibiotics were profiled. Results A total of 97 episodes of BIs occurred in patients during the course of HBV-ACLF. Patients with and without BIs differed in clinical characteristics. The incidence of BIs showed a positive correlation with the ACLF grade (P = 0.003) and the clinical course (P = 0.003). The 90-day transplant-free survival of patients with BIs was lower than those without BIs (P < 0.0001). Patients administered prophylactic antibiotics showed a lower incidence of BIs and had a higher transplant-free survival probability than those who did not (P = 0.046). No statistical differences in antibiotic efficacy between third-generation and other antibiotics were observed (P = 0.108). Conclusions BIs affected the clinical course and prognosis of patients with HBV-ACLF. Prophylactic antibiotics were of potential clinical importance in the prevention of BIs and improving the clinical course and prognosis in HBV-ACLF patients. Third-generation cephalosporins were qualified for use in antibiotic prophylaxis.


1995 ◽  
Vol 85 (9) ◽  
pp. 505-508 ◽  
Author(s):  
M Wakabongo

Motile Aeromonas infections of the foot are caused mostly by post-traumatic incidence, occurring mostly during summer months. Serious complications such as osteomyelitis and amputation can result if the infections go untreated or are inadequately treated. The role of each species of motile Aeromonas in pathogenesis and response to antimicrobial agents is not well understood because of taxonomic uncertainty. As a group, motile Aeromonas respond well to aminoglycosides, second-generation and third-generation cephalosporins, quinolones, and some beta-lactam antibiotics.


2001 ◽  
Vol 22 (1) ◽  
pp. 42-45 ◽  
Author(s):  
Lona R. Mody ◽  
Sharon M. Smith ◽  
Lisa L. Dever

AbstractA case-control study of patients with stools assayed forClostridium difficiletoxin over a 24-month period at a Veterans Affairs hospital found that the majority of cases (70.6%) occurred in temporal clusters. Clustering was particularly evident on a designated human immunodeficiency virus (RW) unit. Thirty-four (75.5%) of 45 HIV-infected patients withC difficile-associated diarrhea (CDAD) died during their hospitalization. Third-generation cephalosporins were the antibiotics most strongly associated with CDAD.


2020 ◽  
Author(s):  
Xiaoqin Liu ◽  
Xueyun Zhang ◽  
Yue Ying ◽  
Jianming Zheng ◽  
Jian Sun ◽  
...  

Abstract Background: Acute-on-chronic liver failure (ACLF) is characterized by an excessive systemic inflammatory response and organ failure and has high mortality. Bacterial infections (BIs) worsen the clinical course of ACLF and carry a poor prognosis in ACLF patients. The efficacy of third-generation cephalosporins has been challenged in recent years. The aim of this study was to characterize the difference between ACLF patients with and without BIs and to provide a reference for medical intervention.Methods: A total of 147 patients with hepatitis B virus-related ACLF (HBV-ACLF) hospitalized at the Department of Infectious Diseases, Huashan Hospital, Fudan University (Shanghai, China) between May 2013 and January 2020 were enrolled. Mann‐Whitney U test was used to compare the baseline characteristics of HBV-ACLF patients with and without BIs. Univariate and multivariate analyses were performed to find predictors of BIs. The characteristics of BIs and the role of prophylactic antibiotics were profiled.Results: A total of 104 episodes of BIs occurred in HBV-ACLF patients either at admission or during hospitalization. Patients with and without BIs differed in clinical characteristics. The incidence of BIs showed a positive correlation with the ACLF grade (P < 0.001) and the clinical course (P < 0.001). The 90-day transplant-free survival of patients with BIs was lower than those without BIs (P < 0.0001). Patients administered prophylactic antibiotics showed a lower incidence of BIs and had a higher transplant-free survival probability than those patients there were not administered prophylactic antibiotics (P = 0.038). No statistical differences in antibiotic efficacy between third-generation and other antibiotics were observed (P = 0.108).Conclusions: BIs affected the clinical course and prognosis of patients with HBV-ACLF. Prophylactic antibiotics were of potential clinical importance in the prevention of BIs and improving the clinical course and prognosis in HBV-ACLF patients. Third-generation cephalosporins were qualified for use in antibiotic prophylaxis.


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