Treatment of Gram-Negative Bacterial Meningitis in Term Neonates with Third Generation Cephalosporins plus Amikacin

2000 ◽  
Vol 77 (3) ◽  
pp. 139-146 ◽  
Author(s):  
H.D. Dellagrammaticas ◽  
Ch. Christodoulou ◽  
E. Megaloyanni ◽  
M. Papadimitriou ◽  
J. Kapetanakis ◽  
...  
Keyword(s):  
Bacterial Meningitis ◽  
Third Generation ◽  
Term Neonates ◽  
Gram Negative ◽  
Third Generation Cephalosporins

scholarly journals The Epidemiology of Meningitis in Infants under 90 Days of Age in a Large Pediatric Hospital

2021 ◽  
Vol 9 (3) ◽  
pp. 526
Author(s):  
Timothy A. Erickson ◽  
Flor M. Munoz ◽  
Catherine L. Troisi ◽  
Melissa S. Nolan ◽  
Rodrigo Hasbun ◽  
...  
Keyword(s):  
Bacterial Meningitis ◽  
Bacterial Infections ◽  
Group B Streptococcus ◽  
Significant Risk ◽  
Viral Meningitis ◽  
Third Generation ◽  
Gram Negative ◽  
E Coli ◽  
Group B ◽  
Third Generation Cephalosporins

Background: Meningitis is associated with substantial morbidity and mortality, particularly in the first three months of life. Methods: We conducted a retrospective review of patients <90 days of age with meningitis at Texas Children’s Hospital from 2010–2017. Cases were confirmed using the National Healthcare Safety Network (NHSN) definition of meningitis. Results: Among 694 infants with meningitis, the most common etiology was viral (n = 351; 51%), primarily caused by enterovirus (n = 332; 95%). A quarter of cases were caused by bacterial infections (n = 190; 27%). The most common cause of bacterial meningitis was group B Streptococcus (GBS, n = 60; 32%), followed by Gram-negative rods other than E. coli (n = 40; 21%), and E. coli (n = 37; 19%). The majority of Gram-negative organisms (63%) were resistant to ampicillin, and nearly one-fourth of Gram-negative rods (23%) other than E. coli and 2 (6%) E. coli isolates were resistant to third-generation cephalosporins. Significant risk factors for bacterial meningitis were early preterm birth and the Black race. Conclusions: Enteroviruses most commonly caused viral meningitis in infants; GBS was the most common bacterial cause despite universal screening and intrapartum prophylaxis. The emergence of MRSA and resistance to third-generation cephalosporins in Gram-negative bacterial meningitis challenges the options for empirical antimicrobial therapy.

▾ Temocillin injection for gram-negative infections only

1991 ◽  
Vol 29 (14) ◽  
pp. 55-56
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Third Generation ◽  
Gram Negative ◽  
Third Generation Cephalosporins

Temocillin (Temopen - SKB) is a penicillin which is β-lactamase-resistant and specifically effective against Gram-negative aerobic organisms. It is active against coliforms resistant to third generation cephalosporins but not against Pseudomonas aeruginosa.1

Norfloxacin: A Quinoline Antibiotic

1986 ◽  
Vol 20 (4) ◽  
pp. 261-266 ◽  
Author(s):  
Dwight A. Marble ◽  
John A. Bosso
Keyword(s):  
Side Effects ◽  
Nalidixic Acid ◽  
Antimicrobial Agents ◽  
Bitter Taste ◽  
Gram Negative Bacteria ◽  
Third Generation ◽  
Gram Negative ◽  
Intravenous Antibiotics ◽  
Third Generation Cephalosporins ◽  
Quinolinecarboxylic Acid

Norfloxacin is a quinoline (quinolinecarboxylic acid) that should prove successful in treating infections that currently require hospitalization and intravenous antibiotics. Although a nalidixic acid derivative, it possesses greater antibacterial activity against gram-positive and gram-negative bacteria. Compared with other antimicrobial agents, norfloxacin is more potent than the aminoglycosides, first-, second-, and third-generation cephalosporins, tetracycline, trimethoprim-sulfamethoxazole, carbenicillin, piperacillin, nalidixic acid, oxolinic acid, cinoxacin, and enoxacin. In the clinical studies to date, the side effects of norfloxacin have been minimal, but include nausea, vomiting, anorexia, dizziness, headache, drowsiness, depression, and a bitter taste in the mouth. In studies with more than 4000 patients, the incidence of side effects ranged from 3.9 to 4.7 percent, with most appearing by the second day of therapy.

scholarly journals Prevelance of Common Organisms Involved in Acute Appendicitis in Althowra Hospital, Elbyda, Libya

2021 ◽  
pp. 76-81
Author(s):  
Salma S. Mohamed ◽  
Nasser Musbah ◽  
Mohamed Sergaiwa
Keyword(s):  
Acute Appendicitis ◽  
Local Population ◽  
Anaerobic Bacteria ◽  
Antibiotic Sensitivity ◽  
Third Generation ◽  
Gram Negative ◽  
Escherchia Coli ◽  
Antibiotic Sensitivity Test ◽  
Third Generation Cephalosporins ◽  
Aerobic And Anaerobic

Background: Bacteria have been involved in the aetiopathogenesis of acute appendicitis. The known of bacteria and antibiotic sensitivity mode will assist in modulating treatment regime for acute appendicitis. Aim: This study aimed to find out the incidence of the offending organisms in acute appendicitis                                  to determine the most effective antibiotic in a local population in Albyda city. Methods: Patients with acute appendicitis presenting between January 2019 and December    2019 were studied, At surgery 1cm rim of appendix was cut from the base and sent into the transport medium. The specimen was cultured for aerobic and anaerobic bacteria, Antibiotic sensitivity test was performed. Results: Sixty patients were conscript; Escherchia coli, gram negative bacilli were the commonest organism isolated. They were sensitive to) ciprofluxacin (65%), chloramphnical (60%) and third generation cephalosporins (52%) resistant to amoxycilin with clavulanic acid and tetracycline. The anaerobes were sensitive to metronidazole (96.5%).

scholarly journals When first line treatment of neonatal infection is not enough: blood culture and resistance patterns in neonates requiring second line antibiotic therapy in Bangui, Central African Republic

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Andrea Nebbioso ◽  
Oluwakemi F. Ogundipe ◽  
Ernestina Carla Repetto ◽  
Calorine Mekiedje ◽  
Hugues Sanke-Waigana ◽  
...  
Keyword(s):  
Blood Culture ◽  
Klebsiella Oxytoca ◽  
Neonatal Infection ◽  
Sub Saharan Africa ◽  
Gram Negative Bacteria ◽  
Third Generation ◽  
Antibiotic Resistant ◽  
Gram Negative ◽  
Sub Saharan ◽  
Third Generation Cephalosporins

Abstract Background Infectious diseases account for the third most common cause of neonatal deaths. Globally, antibiotic resistance (ABR) has been increasingly challenging neonatal sepsis treatment, with 26 to 84% of gram-negative bacteria resistant to third-generation cephalosporins. In sub-Saharan Africa, limited evidence is available regarding the neonatal microbiology and ABR. To our knowledge, no studies have assessed neonatal bacterial infections and ABR in Central-African Republic (CAR). Therefore, this study aimed to describe the pathogens isolated and their specific ABR among patients with suspected antibiotic-resistant neonatal infection admitted in a CAR neonatal unit. Methods This retrospective cohort study included neonates admitted in the neonatal unit in Bangui, CAR, from December 2018 to March 2020, with suspected antibiotic-resistant neonatal infection and subsequent blood culture. We described the frequency of pathogens isolated from blood cultures, their ABR prevalence, and factors associated with fatal outcome. Results Blood cultures were positive in 33 (26.6%) of 124 patients tested (17.9% for early-onset and 46.3% for late-onset infection; p = 0.002). Gram-negative bacteria were isolated in 87.9% of positive samples; with most frequently isolated bacteria being Klebsiella pneumoniae (39.4%), Escherichia coli (21.2%) and Klebsiella oxytoca (18.2%). All tested bacteria were resistant to ampicillin. Resistance to third-generation cephalosporins was observed in 100% of tested Klebsiella pneumoniae, 83.3% of isolated Klebsiella oxytoca and 50.0% of tested Escherichia coli. None of the tested bacteria were resistant to carbapenems. Approximately 85.7 and 77.8% of gram-negative tested bacteria were resistant to first-line (ampicillin-gentamicin) and second-line (third-generation cephalosporins) treatments, respectively. In hospital mortality, adjusted for blood culture result, presence of asphyxia, birth weight and sex was higher among neonates with positive blood culture (adjusted relative risk [aRR] = 2.32; 95% confidence interval [CI] = 1.17–4.60), male sex (aRR = 2.07; 95% CI = 1.01–4.26), asphyxia (aRR = 2.42; 95% CI = 1.07–5.47) and very low birth weight (1000–1499 g) (aRR = 2.74; 95% CI = 1.3–5.79). Conclusion Overall, 77.8% of confirmed gram-negative neonatal infections could no longer effectively be treated without broad-spectrum antibiotics that are not routinely used in sub-Saharan Africa referral hospitals. Carbapenems should be considered an option in hospitals with surveillance and antibiotic stewardship.

Cefepime: A Fourth-Generation Parenteral Cephalosporin

1996 ◽  
Vol 30 (12) ◽  
pp. 1414-1424 ◽  
Author(s):  
Michael A Wynd ◽  
Joseph A Paladino
Keyword(s):  
Clinical Trials ◽  
Clinical Efficacy ◽  
Fourth Generation ◽  
Third Generation ◽  
Gram Positive ◽  
Gram Negative ◽  
Beta Lactamases ◽  
Tract Infections ◽  
Third Generation Cephalosporins

OBJECTIVE: To review the chemistry, microbiology, pharmacokinetics, therapeutic efficacy, adverse effect profile, drug interactions, dosing, and administration of cefepime, a new fourth-generation parenteral cephalosporin. DATA SOURCES: A MEDLINE search of the available literature, including clinical trials and reviews, was performed. Abstracts presented at recent scientific conferences and current publications were also reviewed. DATA SELECTION: In vitro and preclinical data were included, as well as data from Phase II and III clinical trials. DATA SYNTHESIS: Cefepime is an extended-spectrum parenteral cephalosporin antibiotic active in vitro against a broad spectrum of gram-positive and gram-negative aerobic bacteria. The gram-positive spectrum is similar to that of cefotaxime, the gram-negative spectrum is similar to that of ceftazidime, and many, though not all, organisms resistant to these two agents remain susceptible to cefepime, prompting the fourth-generation designation. Cefepime has a high affinity for penicillin-binding proteins and, due to its zwitterionic configuration, rapidly penetrates outer-membrane porin channels of bacteria. Beta-lactamases appear to have a low affinity for the drug. Cefepime has a decreased propensity to induce beta-lactamases compared with other beta-lactam antibiotics. Cefepime has a pharmacokinetic disposition similar to that of other renally eliminated cephalosporins, with a half-life of approximately 2 hours. Cefepime has demonstrated clinical efficacy against a variety of infections, including urinary tract infections, pneumonia, and skin and skin structure infections. Cefepime is generally well tolerated. CONCLUSIONS: Cefepime may have several chemical and pharmacologic advantages over currently available third-generation cephalosporins. In vitro data indicate that cefepime retains activity against some, but not all, gram-negative bacteria resistant to third-generation cephalosporins; however, clinical efficacy against infections due to resistant pathogens remains to be established. Cefepime was at least as effective as comparators during clinical trials, and may prove to be a viable alternative to other currently available agents.

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