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Biomedical subjects

L J Eron

Publications and source records attributed to L J Eron.

At least 55 records · Page 3Linked to original sources

Ceftazidime in patients with Pseudomonas infections.

Ceftazidime was administered to 41 patients with serious infections caused by Pseudomonas aeruginosa (24 cases) and other bacteria (17 cases). The clinical response rate of pseudomonas infections (88%) was similar to that of other bacteria (94%) with microbiological eradication of 83% of initial pseudomonas isolates compared to 82% of non-pseudomonas strains. The development of resistance to ceftazidime during therapy was observed in 3 cases (Enterobacter agglomerans, Enterobacter cloacae, and Ps. aeruginosa), and superinfection by a resistant Enterobacter agglomerans occurred in one case. Adverse reactions of clinical significance included two cases of leukopenia and one case each of azotaemia, diarrhoea (Clostridium difficile toxin positive), and rash.

Abscess↗

Piperacillin therapy for Pseudomonas infections.

Piperacillin, a new broad spectrum semisynthetic penicillin derivative, was administered to 22 patients with 25 Pseudomonas aeruginosa infections. All initially responded favorably, although five complicated urinary tract infections and two infections involving prostheses relapsed. In 15 cases, microbiologic eradication of the Pseudomonas was achieved. Failure to achieve a clinical cure was correlated in all cases with the inability to eradicate the organism, which was the result of development of in vitro resistance to piperacillin during therapy (four cases) and of underlying disease impairing host responses. Adverse reactions to piperacillin included leukopenia (eight cases) and nephrotoxicity (two cases).

Adolescent↗

Ceftazidime therapy of serious bacterial infections.

Ceftazidime, a new broad-spectrum cephalosporin, was administered to 30 patients with serious bacterial infections in a randomized dosing trial with daily doses of 1.5 or 3 g. Both regimens were equally efficacious, with satisfactory clinical responses in 28 instances (93%) and microbiological eradication of 79% of initial bacterial isolates. The development of resistance to ceftazidime during therapy was observed in three cases (Enterobacter agglomerans, Enterobacter cloacae, and Pseudomonas aeruginosa) and superinfection by a resistant Enterobacter agglomerans strain occurred in one case. Adverse reactions of clinical significance included one case each of leukopenia, azotemia, diarrhea (Clostridium difficile toxin positive), and rash.

Adolescent↗

Ceftriaxone therapy of bone and soft tissue infections in hospital and outpatient settings.

Ceftriaxone, a broad-spectrum cephalosporin with a markedly extended half-life, was administered to 100 patients with 56 bone and 44 soft tissue infections. Sixty-eight received 1 g twice daily, and 32 received 2 g once daily intravenously. Overall, 91% had a satisfactory clinical response, with similar efficacies in both treatment regimens. In six patients, failure to achieve a cure correlated well with the development of resistance to ceftriaxone during therapy in Enterobacter and Pseudomonas species (two cases) and with superinfection with Bacteroides fragilis (four cases). In 41 patients, intravenous drug therapy was continued after discharge from the hospital. In this group, 1,093 patient-days of hospitalization were saved, amounting to $150,020 in cost savings. The prolonged half-life facilitated the administration of ceftriaxone in this setting.

Adolescent↗

Imipenem versus moxalactam in the treatment of serious infections.

Imipenem (formerly imipemide, N-formimidoyl thienamycin, or MK0787) was compared to moxalactam in a randomized therapeutic trial involving 39 evaluable patients with serious bacterial infections. Of those treated with imipenem, 89% were cured or improved versus 60% for moxalactam (P = 0.06). Although mucocutaneous fungal infections occurred in both groups (25 and 10%, respectively), Streptococcus faecalis superinfection was seen in two patients in the moxalactam group only. Adverse drug reactions occurred with both drugs, although bleeding occurred in three patients treated with moxalactam.

Adult↗

Intravenous antibiotic therapy in an outpatient setting.

A program has been developed for the outpatient administration of parenteral antibiotics. To date, more than 150 patients with osteomyelitis, septic arthritis, pyelonephritis, endocarditis, and other infections have been treated. Antibiotic solutions were prepared in the hospital pharmacy and given to the patient to be kept refrigerated at home until used. Patients administered their own antibiotics by means of a heparin lock, which was replaced every four days or when necessary. Complications were infrequent. Many patients were able to return to work while receiving therapy; others enjoyed the comfort of being at home. Cost reductions were substantial, calculated to be at least $142 a day, or the charge for a semiprivate room in 1981. In addition to the cost savings, critically needed hospital beds were freed for more acutely ill patients.

Adolescent↗

Fatal pulmonary embolism in an adolescent with chickenpox.

A fatal case of pulmonary emboli associated with varicella in an adolescent is reported. Review of the literature revealed confusion between pulmonary infarction and embolization, the latter having been documented with varicella only in adults before this report. Embolic phenomena should be considered in the differential diagnosis of pulmonary symptoms associated with varicella, since their recognition and treatment offers important supportive measures in the care of the frequently critically ill patients.

Adolescent↗

Cell-free synthesis of measles virus proteins.

Polyadenylated mRNA extracted from cytoplasm of measles virus-infected Vero cells was translated in a cell-free system. Three of the polypeptides obtained corresponded to nucleocapsid protein, phosphoprotein, and membrane protein of measles virions. A fourth polypeptide, present in measles virus-infected cells, could be generated by addition of Vero cytoplasmic extract and was identified as a cleavage product of the nucleocapsid protein.

Capsid↗

Targeting lurking pathogens in acute traumatic and chronic wounds.

The appropriate antimicrobial treatment for skin and soft tissue following acute trauma is determined by the mechanism of injury, time from injury to treatment, environmental wound contamination, pathogenicity of colonizing bacteria, and patient-specific issues. These factors can be used to predict the risk of secondary infection of wounds. Although common skin pathogens (such as Staphylococcus aureus and group A Streptococcus) cause most secondary wound infections, antibiotic therapy sometimes must be directed against unusual pathogens that are associated with atypical wounds, such as animal bites (amoxicillin with clavulanate for Pasteurella multocida) and plantar puncture wounds (ciprofloxacin for Pseudomonas aeruginosa). This customized treatment approach is also appropriate for chronic wounds, such as pressure and diabetic foot ulcers. In addition to antibiotic therapy, wound management may include surgical debridement. Active areas of investigation in wound management include the use of growth factors and hyperbaric oxygen.

Acute Disease↗

Intravenous antibiotic therapy in ambulatory pediatric patients.

Eighty-nine pediatric patients (median age, 12.0; range, 1.5 to 18 years) were treated with antibiotics given intravenously by self- or parent administration for a variety of infections, under close physician supervision. Patients with infections involving bone and joint (53), respiratory tract (16), soft tissue (9), abdominal cavity (4), genitourinary tract (4) and bloodstream (3) were treated for a mean period of 19.0 days. Staphylococcus aureus, Pseudomonas aeruginosa and Haemophilus influenzae were the most frequent pathogens. Favorable clinical outcomes occurred in 85 patients (96%). Adverse clinical and laboratory events occurred at a frequency commensurate with that of hospitalized patients. A total of 1700 patient days were managed in this outpatient setting at significant cost savings, and the method allowed early return to school for 83 patients (93%). Intravenous antibiotic therapy in ambulatory patients can provide a successful, safe, cost-effective alternative to inpatient care under conditions of diligent patient screening and physician-centered follow-up.

Adolescent↗

Multicenter study of a single 500-mg dose of cefotaxime for treatment of uncomplicated gonorrhea.

One hundred thirty-seven evaluable patients with uncomplicated gonorrhea were treated with a single 500-mg intramuscular dose of cefotaxime. All isolates were susceptible to concentrations of cefotaxime less than or equal to 0.1 microgram/ml. The minimum concentration of cefotaxime needed to inhibit 90% of isolates was less than 0.04 microgram/ml. At follow-up, infection was eradicated in 181 of 187 (97%) infection sites. Bacteriologic cures of 100 of 101 (99%), 55 of 56 (98%), 23 of 25 (92%), and 3 of 5 (60%) were attained at the urethral, endocervical, rectal, and oropharyngeal sites, respectively. Side effects were minor, and 90% of patients rated the injection-site pain as absent or mild. A single 500-mg dose of cefotaxime is an effective, economic treatment for uncomplicated gonorrhea.

Adult↗