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Biomedical subjects

C Quentin

Publications and source records attributed to C Quentin.

At least 55 records · Page 3Linked to original sources

[Clinical and bacteriological evaluation of cefmenoxime in the newborn infant].

Cefmenoxime (CMX) has been administered under parenteral injection to 39 neonates delivered at term, nearly always by monotherapy in an average dosage of 86.8 mg/kg/day. CMX has been used 31 times in first line therapy and 8 times after failure of association Ampicillin-Gentamicin. 25 strains have been identified: 16 E. coli (9 Ampicillin resistant), 7 P. mirabilis (1 Ampicillin resistant), 1 K. oxytoca and 1 Streptococcus B. The neonates group with septicaemia (1 with arthritis) has been cured without after-effects as urinary tract infections and systemic infections. 2 respiratory tract infections have been improved, the others have been cured. Bacterial samples have always been sterilized within 2 days. Local tolerance (IV or/and IM injection) has been very good. No clinical or biological abnormality has been imputed to treatment. Cefmenoxime appears very effective on enterobacteriaceae (MIC range 0.05-0.5 mg/l) and can be used in newborn infections.

Bacterial Infections↗

[In vitro activity of new quinolones against Mycoplasma pathogenic to humans].

The in vitro activity of new quinolones was evaluated against Mycoplasma pneumoniae (10 strains) and Mycoplasma hominis (approximately equal to 70 strains) by agar dilution, and against Ureaplasma urealyticum (approximately equal to 115 strains) by broth dilution. The static effect of pefloxacin, ofloxacin, ciprofloxacin, enoxacin was investigated for all the strains. Rosoxacin was included in the tests for U. urealyticum and M. hominis. Pefloxacin, ofloxacin, ciprofloxacin and enoxacin were within the same range of sensitivity for M. pneumoniae; the minimal inhibitory concentrations (MICs) of the 10 strains were 1 mg/l for ciprofloxacin, 2 mg/l for pefloxacin, MICs range was (0.05-1 mg/l) for ofloxacin and (0.5-4 mg/l) for enoxacin. Ciprofloxacin was the most active compound against M. hominis; MICs range and mode MICs were respectively in mg/l: (0.1-1) 0.5 for ciprofloxacin, (0.2-2) 0.5 for ofloxacin, (0.5-2) 1 for pefloxacin, (0.5-8) 2 for enoxacin, (2-16) 2 for rosoxacin. Ofloxacin was the most active compound against U. urealyticum; MICs range and mode MICs were respectively in mg/l: (0.2-2) 1 for ofloxacin, (0.1-8) 2 for rosoxacin, (0.5-8) 4 for pefloxacin, (1-16) 4 for ciprofloxacin, (2-32) 8 for enoxacin. No difference could be observed between tetracycline sensitive or resistant strains.

4-Quinolones↗

[Study of an epidemic of Clostridium difficile-associated diarrhea].

Twenty three Clostridium difficile strains isolated from diarrheic faecal samples of 22 patients in a neurosurgical department of the Pellegrin Hospital in Bordeaux between January 1984 and May 1987 (15 isolated in 1984, 2 in 1985, 3 in 1986 and 3 in 1987) and 15 strains isolated from 15 patients in other departments of the same hospital in 1984 have been compared using their antimicrobial susceptibility, cytotoxin production and electrophoretic pattern. Twelve of the 15 strains isolated in the neurosurgical department and 4 of the 15 strains isolated in other departments in 1984 were phenotypically identical. These findings suggest that the origin of C. difficile associated-diarrheas can be nosocomial.

Adolescent↗

Pharmacokinetics of intravenous and intraperitoneal fosfomycin in continuous ambulatory peritoneal dialysis.

Kinetics of fosfomycin were investigated in six patients undergoing continuous ambulatory peritoneal dialysis. Each subject received both an i.v. and an i.p. 1 g dose of fosfomycin with a one week washout between doses. Fosfomycin was assayed by a microbiological diffusion technique. After intravenous injection the fosfomycin serum kinetic parameters were as followed: elimination half-life (t1/2 beta) 38.4 +/- 8.7 h; volume of distribution 0.32 +/- 0.02 l/kg; total plasma clearance 7.0 +/- 1.4 ml/min and peritoneal clearance 3.2 +/- 0.2 ml/min. Dialyzate fosfomycin concentrations reached a maximum mean value of 32.2 +/- 2.8 micrograms/ml at 4 h post-injection and fosfomycin was detectable in dialyzate samples for up to 72 hours post-dosing. After intraperitoneal instillation, fosfomycin appeared in the serum rapidly and the mean peak plasma concentration was 36.2 +/- 2.8 micrograms/ml at the 4th h. The absorption rate (ka) was 0.580 +/- 0.039 h-1 and the absorption of fosfomycin from peritoneal space was 68.4 +/- 6.0%. These data suggest a bidirectional exchange through the peritoneal membrane. Intraperitoneal administration of 1 g either 48 h apart for anephric patients or 36 h apart for patients with residual renal function may achieve therapeutic serum concentrations.

Female↗

In vitro activity of fosfomycin combined with rifampin, pefloxacin and imipenem against staphylococci: a study by the time-kill curve method.

The in vitro activity of fosfomycin alone and in combination with rifampin, pefloxacin and imipenem was studied by the time-kill method against staphylococci. Fosfomycin, pefloxacin and imipenem used at concentrations within the therapeutic range, exerted a bactericidal effect, whereas rifampin acted as a bacteriostatic drug. The combination of fosfomycin and rifampin was found to be antagonistic against rifampin-susceptible strains and indifferent for rifampin-resistant isolates. Fosfomycin combined with pefloxacin usually produced an indifferent effect. The interaction between fosfomycin and imipenem was mainly indifferent but synergism occurred with methicillin-resistant strains and antagonism was observed for one methicillin-susceptible isolate of Staphylococcus aureus.

Anti-Bacterial Agents↗

[In vitro action of fosfomycin combined with rifampicin, pefloxacin and imipenem on staphylococci (checkerboard method in a liquid medium)].

The combined activity of fosfomycin with rifampin, pefloxacin and imipenem was investigated, by the checkerboard method performed in liquid medium, against 50 clinical isolates of staphylococci (25 Staphylococcus aureus and 25 coagulase-negative staphylococci). The combination of fosfomycin plus rifampin had an additive bacteriostatic effect and an antagonistic bactericidal effect. Fosfomycin combined with pefloxacin was found to be additive or moderately synergistic. Fosfomycin in combination with imipenem was generally highly synergistic, especially against meticillin-resistant strains; however the bactericidal effect was occasionally antagonistic.

Anti-Bacterial Agents↗

The activity of ticarcillin in combination with clavulanic acid against Bacteroides species: an in-vitro comparison with other antibiotics.

The in-vitro activity of ticarcillin alone and with 4 and 8 mg/l of clavulanic acid, has been studied on 100 strains of Bacteroides (66 Bacteroides fragilis, 13 B. ovatus, 11 B. vulgatus, 6 B. distasonis, 4 B. thetaiotaomicron) by an agar-dilution method and compared to that of latamoxef cefoxitin, cefotaxime, ceftizoxime, ceftriaxone, cefmenoxime, ceftazidime and metronidazole. All the strains tested were susceptible to the combination of ticarcillin-clavulanic acid (MIC less than or equal to 8 mg/l), to metronidazole (MIC less than or equal to 4 mg/l), and to cefoxitin (MIC less than or equal to 32 mg/l). The combination of ticarcillin and clavulanic acid has an activity superior to that of ticarcillin alone. The MIC90 was 32 mg/l for ticarcillin alone, 1 and 0.5 mg/l for ticarcillin combined with 4 and 8 mg/l of clavulanic acid respectively. Against all the tested strains, cefoxitin was the most active of the cephalosporins, followed by latamoxef (3% of all strains with an MIC greater than 32 mg/l), cefotaxime (5%), ceftizoxime (9%), ceftriaxone (13%), cefmenoxime (17%) and ceftazidime (33%). Differences in sensitivity to cephalosporins were observed within species; the B. ovatus was clearly more resistant than B. fragilis and B. vulgatus. In all species, the combination of ticarcillin and clavulanic acid was always highly active, with MICs less than or equal to 0.01-8 mg/l.

Bacteroides↗

[Clinical evaluation of ceftriaxone in severe infections in adults].

Thirty patients (17 male, 13 female; age 17 to 84 years; normal renal function in 23 cases) with severe bacterial infections were treated with ceftriaxone. The infections was septicemia in 20 cases, a septicemia-like condition in 2 and a focal infection in 8 (2 abscesses of the lung, 2 pyelonephritis, 1 abscess of the liver, 1 subphrenic abscess, 1 meningitis developed from an abscess of the brain and 1 acute intestinal infection). 25 infections were bacteriologically documented, with recovery of the following pathogens: 20 Gram negative rods (including 10 E. coli) that were all susceptible to ceftriaxone (MIC = 0.02 to 0.5 mg/l) except 2 (1 Pseudomonas and 1 E. cloacae), 5 susceptible Gram positive cocci (3 Pneumococcus, 1 Streptococcus and 1 Staphylococcus epidermidis) and 3 susceptible anaerobes (2 B. fragilis and 1 B. melaninogenicus). Ceftriaxone was given alone in 15 cases and in association with another antibiotic in 15 cases (aminoglycoside in 10 cases, nitroimidazole in 4 and fosfomycin in 1). The dose of ceftriaxone was 1 to 2 g per day in 28 cases, 3 g per day in 1 case (meningitis with abscess of the brain) and 1 g every other day in 1 case (chronic renal failure under hemodialysis). Duration of treatment ranged from 10 to 62 days (average 17 days). The usual routes of administration were IV and IM; the SC route was used on 4 occasions. Pharmacokinetic studies of serum levels were carried out in several patients including two who had ceftriaxone subcutaneously; results were consistent with those previously reported in the literature.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Isolation of Clostridium difficile from the stools of hospitalized patients with diarrhea].

408 stool samples from 354 hospitalized patients with diarrhea were evaluated for the presence of Clostridium difficile. C. difficile was detected in stools of 42 patients (12%), 19 of them being hospitalized in neurosurgery units. The strains were cytotoxigenic in 31 cases and non cototoxigenic in 11 cases. The diagnosis of C. difficile induced diarrhea was based on the clinical setting [presence of diarrhea that could be attributed to antimicrobial therapy and endoscopy for detection of pseudomembranous colitis (PMC)], laboratory studies (cytotoxigenic strains of C. difficile) and therapeutic response (oral vancomycin or metronidazole). C. difficile was implicated as a cause of PMC (2 cases) and antimicrobial associated diarrhea (8 cases) (PMC not documented). The pathogenic role of C. difficile was questionable in 24 cases (no specific therapy) and unlikely in 8 cases. In fact C. difficile could be implicated as a cause of diarrhea in 24% of the cases.

Clostridium↗

[Antibiotic sensitivity of Mycoplasma pathogenic for man].

Human pathogen mycoplasmas (Mycoplasma pneumoniae, Mycoplasma hominis, Ureaplasma urealyticum) are intrinsically resistant to antibiotics which inhibit the cell wall biosynthesis (beta-lactams, vancomycin, bacitracin), to polymyxins, rifamycins, sulfonamides, trimethoprim, 5-nitroimidazoles, nitrofurans and to presently available quinolones. These three species are moderately susceptible to aminoglycosides, susceptible to chloramphenicol and highly susceptible to tetracyclines. M. pneumoniae is susceptible to macrolides, lincosamins and streptogramins. M. hominis is resistant to early macrolides (erythromycin, oleandomycin, spiramycin) and susceptible to new macrolides (josamycin, midecamycin, rosaramicin), lincosamins and streptogramins. U. urealyticum is resistant to lincosamins and susceptible to macrolides and streptogramins. Discordant results from various reports can be explained by differences in methods and breakpoint concentration values. In M. pneumoniae species, two strains resistant to macrolides and lincosamins have been described. In M. hominis species, one strain resistant to tetracyclines and another one resistant to tetracyclines and chloramphenicol have been reported. Two to ten percent of U. urealyticum strains are resistant to tetracyclines. These resistances are likely to be plasmid-mediated.

Anti-Bacterial Agents↗

[Comparative activity of minocycline and doxycycline on mycoplasmas pathogenic for man].

Susceptibility of Mycoplasma pneumoniae (10 strains), Mycoplasma hominis (20 strains) and Ureaplasma urealyticum (100 strains) to minocycline and doxycycline was studied in vitro. Minimal inhibitory concentrations were determined using an agar dilution method for M. pneumoniae and M. hominis and a metabolic inhibition test for U. urealyticum. M. pneumoniae strains were highly susceptible to minocycline and doxycycline (MIC less than or equal to 0.1 mg/l). Among M. hominis strains, 17 were susceptible (MIC less than or equal to 0.1 mg/l), whereas 3 were inhibited only by concentrations ranging from 4 to 16 mg/l. Among the 100 U. urealyticum strains, 95 were inhibited by 4 mg/l minocycline and 94 by 4 mg/l doxycycline. Both antibiotics exhibited similar activities against the three species (same ranges, same mode MICs).

Doxycycline↗

[Clinical evaluation of a ticarcillin-clavulanic acid combination in severe infections in adults].

Timentin (ticarcillin (TCR) + clavulanic acid (AC)) was given for severe bacterial infections to sixteen hospitalized patients (10 male and 6 female; 16 to 75 years of age; normal renal function in 12). Infections included 8 septicemias (of which 4 were secondary to pyelonephritis), 6 pyelonephritis (in addition to the four above-mentioned cases), and 3 suppurated cellulitis of the lower limbs (with septicemia in one case). The following bacteria were recovered: 10 Escherichia coli, 1 Pseudomonas aeruginosa, 1 Enterobacter cloacae, 1 Providencia stuartii, 1 Salmonella typhi, 1 Klebsiella pneumoniae, and 1 Staphylococcus aureus. The sixteen strains were all susceptible to timentin (MICs determined by agar dilution: TCR + AC 4 mg/l: 0.5-16 mg/l; TCR + AC 8 mg/l: 0.2-16 mg/l). Thirteen strains were susceptible to TCR (MIC less than or equal to 16 mg/l), and three (1 E. coli, 1 K. pneumoniae, and 1 S. aureus) were resistant to TCR (MIC greater than or equal to 256 mg/l). 14 patients received timentin alone, while two were also given dibekacin. Timentin was given in one-hour IV infusions in a dosage of 9.6 g/24 h (3.2 g X 3) in 10 patients and 6.4 g/24 h (3.2 g X 2) in 6. Duration of therapy was 14 to 16 days in half of cases (range 5 to 21 days). At termination of the infusion, serum concentrations of ticarcillin and clavulanic acid (determined in ten patients) were greater than 50 mg/l and 3-7.4 mg/l respectively, and serum bactericidal activity (evaluated in ten cases) was consistently less than 1/2.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Influence of chlorhexidine on the flora of burns].

The effect of chlorhexidine baths on surface and in-depth colonization of burns was studied in 12 severely burned patients. 202 swabs and 202 biopsy specimens were cultured. Each patient was sampled before and after a daily chlorhexidine bath on several days. Subsequent to bathing, 41% of swabs became sterile and a 1.41 log10 reduction in the number of germs in biopsy specimens was observed. However, deep flora was unchanged in almost half of cases (43.3%) and was reduced by only 1 to 2 log10 in one-third of cases (35.3%). Chlorhexidine added to baths inhibited surface bacterial growth but had an inconsistent and limited effect on in-depth colonization.

Adolescent↗

Pharmacokinetics of fosfomycin in hemodialyzed patients.

The pharmacokinetics of fosfomycin, an original antimicrobial agent, were investigated in 11 voluntary hemodialyzed patients. Fosfomycin, 2 g, was administered intravenously, 15 minutes before hemodialysis began in group 1 (6 patients), and just after hemodialysis in group 2 (6 patients). Blood samples were collected during 8 hours (group 1) and during 44 hours (group 2). Antibiotic concentrations were determined microbiologically. In group 1, half-life was 4.2 +/- 0.27 hours, total clearance 65.1 +/- 7.1 ml/mn and clearance by hemodialyzer 103 +/- 10 ml/mn. In group 2 plasma levels were 60 mg/l at the 44th hour and half-life was 48.8 +/- 17.5 hours. These results suggest that fosfomycin is actively eliminated by the hemodialyzer in group 1, and largely retained between two dialysis sessions in group 2. As for therapy, intravenous administration of 2 g after dialysis and further administration after each succeeding session are proposed.

Adult↗

[Bacteriostatic activity of apalcillin on Gram-negative bacilli and strict anaerobic bacteria. Multicenter study].

This work reports a multicenter study of the bacteriostatic activity of apalcillin, a new N-acyl-penicillin, against 1 827 clinical isolates of Gram-negative bacilli and obligate anaerobes. The modal minimal inhibitory concentrations (MICs) for susceptible strains are (mg/l) : Salmonella-Shigella : 1 ; E. coli : 0.5-2 ; Klebsiella : 4 ; Citrobacter : 1-2 ; Enterobacter : 2 ; Serratia : 8 ; Proteus-Providencia : 1 ; Acinetobacter : 1-4 ; P. aeruginosa : 2 ; H. influenzae : 0.06 ; C. perfringens : 0.03-01 ; Peptococcus : 0.2 ; B. fragilis : 16. Against Enterobacteriaceae and Acinetobacter, apalcillin is as active as mezlocillin and piperacillin, and much more than carbenicillin. Against P. aeruginosa, apalcillin is the most active penicillin : 2 to 16 fold more active than azlocillin and piperacillin, and 2 to 128 fold more active than ticarcillin. Against H. influenzae, C. perfringens and Peptococcus, apalcillin has MICs similar to those of other N-acyl penicillins, and inferior to those of carboxypenicillins . Apalcillin, as other penicillins, is poorly active against B. fragilis.

Ampicillin↗

[Pharmacokinetics of apalcillin. Study of linearity].

Apalcillin is a new semi-synthetic penicillin active on the positive Gram bacteria, and on the enterobacteria, with a particular activity on Pseudomonas and Acinetobacter. The linearity study of the pharmacokinetic was carried out on 26 subjects who were given increasing doses (500, 1 000, 2 000, 3 000 mg) of apalcillin by the venous route. The dosages carried out by the HPLC and bacteriological methods, show a good correlation between the two methods. The serum concentrations, 5 mn. after injection, were respectively 72 micrograms/ml (500 mg); 145 micrograms/ml (1 g) ; 221 micrograms/ml (2 g) ; 290 micrograms/ml (3 g). Urinary excretion is around 20 %, and this, regardless of the dose. The dose increase seems to have no effect on the pharmacokinetic parameters, calculated on the basis of a bi- compartmental model. The areas under the time serum concentrations, increase proportionally, to the dose : 61 (500 mg) ; 146 (1 g) ; 285 (2 g) ; 367 (3 g) - micrograms/ml X h. the linear regression between the AUC (y) and the applied doses (X) is : y = 0,12 X + 14,27 ; r = 0,9046 ; n = 69. The correlation between the AUC and the doses is significant (p less than 0,001). The results obtained show that increasing the dosage has no effect on apalcillin pharmacokinetics, which appear linear.

Adult↗

[Comparative bacteriostatic activity of ticarcillin, alone and combined with clavulanic acid, 5 cephalosporins and metronidazole against 100 strains of Bacteroides fragilis].

In vitro activity against 100 strains of Bacteroides fragilis of ticarcillin alone and combined with 4 or 8 mg of clavulanic acid was compared with those of cefoxitin, cefotaxime, ceftazidime, lamoxactam , ceftriaxone and metronidazole. The Cl 90 was 29.7 mg/l for ticarcillin alone, and 1.3 and 0.5 mg/l for ticarcillin combined with 4 and 8 mg of clavulanic acid respectively. Every strain was susceptible to ticarcillin combined with clavulanic acid (CMI less than or equal to 16 mg/l) and metronidazole (CMI less than or equal to 4 mg/l). Among the cephalosporins tested, lamoxactam (Cl 90 : 1 mg/l) was the most active, followed by cefotaxime (22.7 mg/l), cefoxitin (23 mg/l), ceftriaxone (51.2 mg/l) and ceftazidime (347 mg/l).

Bacteroides fragilis↗