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N Blagg

Publications and source records attributed to N Blagg.

5 recordsLinked to original sources

Community-acquired bacteremic urosepsis in the elderly patients: a prospective study of 34 consecutive episodes.

A prospective study was done on the clinical, laboratory, radiological, immunological and therapeutic features of acute, symptomatic, bacteremic urosepsis in 34 consecutive, elderly patients who required hospitalization. Urinary tract infection was identified as the most common cause of gram-negative bacteremia in elderly patients admitted to a community hospital. Appropriate antibiotic therapy and a lack of serious associated medical illnesses contributed to the high survival rate. Bacteremia and shock occurring in the wake of pyelonephritis develop more commonly in elderly than in young women. In the elderly patient with bacteremia and pyelonephritis radiographic evaluation invariably demonstrates obstruction to urine flow, calculous disease or abscess. Guidelines are provided for the therapy of acute, symptomatic bacteremic urosepsis.

Aged↗

Acute pyelonephritis in the elderly.

We did a prospective study of the clinical, laboratory, radiologic, and therapeutic features of acute, symptomatic, bacterial pyelonephritis in 35 consecutive elderly, noncatheterized patients who required hospitalization. Pyelonephritis had been identified as the most common cause of gram-negative bacteremia in elderly patients admitted to a community hospital. Appropriate antibiotic therapy and, of equal importance, a lack of serious associated medical illnesses contributed to the 97% survival. Two features appear to distinguish acute, symptomatic, bacterial pyelonephritis in elderly women from that in young women: an increased incidence of bacteremia and septic shock. We provide guidelines for the diagnostic evaluation and antibiotic therapy of acute, symptomatic, community-acquired, bacterial pyelonephritis in the elderly.

Acute Disease↗

Symptomatic pyelonephritis in elderly men.

A prospective study was carried out of the clinical, laboratory, radiologic and therapeutic features of acute, symptomatic, bacterial pyelonephritis as experienced by 12 consecutive elderly, noncatheterized men who required hospitalization. In spite of the advanced ages of the men and the inordinate frequency of bacteremia and septic shock, no patient died. "Appropriate" antibiotic therapy, supportive treatment, and, as importantly, a lack of associated "imminently" or "ultimately" fatal illnesses contributed to the 100 per cent survival rate. Guidelines are provided for the diagnostic evaluation and antibiotic therapy of community-acquired pyelonephritis in elderly men.

Aged↗

Trimethoprim: mechanisms of action, antimicrobial activity, bacterial resistance, pharmacokinetics, adverse reactions, and therapeutic indications.

Trimethoprim has recently been marketed as a single-entity product for the treatment of initial episodes of uncomplicated symptomatic urinary tract infections; it was previously available only in combination with sulfamethoxazole. Trimethoprim exerts antimicrobial activity by blocking the reduction of dihydrofolate to tetrahydrofolate, the active form of folic acid, by susceptible organisms. It has inhibitory activity for most gram-positive aerobic cocci and some gram-negative aerobic bacilli. Resistance to trimethoprim may be either intrinsic or acquired. Acquired resistance most commonly stems from a chromosomal mutation that results in the production of a dihydrofolate reductase enzyme which is less vulnerable to trimethoprim inhibition. Gastrointestinal intolerance and skin eruptions are the most common untoward reactions resulting from the administration of trimethoprim. Trimethoprim constitutes very effective therapy for women with acute symptomatic urinary tract infections caused by E. coli, and the compound compares favorably with alternative standard agents, such as ampicillin and cephalexin. The safety of trimethoprim in the pregnant woman has not been established. Since indiscriminate use of trimethoprim could foster the emergence of trimethoprim resistance, thereby negating the value of both trimethoprim and trimethoprim-sulfamethoxazole, trimethoprim should only be prescribed for well defined indications. Trimethoprim is currently being investigated as definitive therapy for a wide range of infections, including bacterial exacerbations of chronic bronchitis, bacterial pneumonia, and typhoid fever. Initial reports are encouraging.

Bacterial Infections↗