PubMed Health⌕ Search

Biomedical subjects

R W Busuttil

Publications and source records attributed to R W Busuttil.

368 records · Page 21Linked to original sources
PubMedDate not supplied

Ganciclovir therapy for cytomegalovirus infections in recipients of bone marrow transplants and other immunosuppressed patients.

The efficacy and safety of ganciclovir were evaluated for the treatment of 39 life-threatening or sight-threatening cytomegalovirus (CMV) infections in recipients of bone marrow transplants (15 patients), recipients of liver or renal transplants (8 patients), patients with AIDS (11 patients), and one patient each with lymphoma or systemic lupus erythematosus. Twenty-eight (72%) of 39 CMV infections improved during ganciclovir therapy, which was associated with elimination of CMV from cultures. Improvement occurred more frequently in patients with viremia, fever, and wasting (8 of 8), hepatitis (3 of 4), retinitis (5 of 5), or colitis (1 of 1), than in patients with pneumonia (11 of 21). Only two of nine marrow transplant recipients with CMV pneumonia survived, as compared with nine of 12 other immunosuppressed patients with pneumonia. However, all six marrow transplant recipients who were treated for CMV viremia, fever, and wasting without pneumonia survived. Neutropenia was the only adverse reaction associated with ganciclovir therapy and was more frequent in patients with AIDS (6 [55%] of 11) than in transplant recipients (5 [20%] of 25). These results suggest that ganciclovir is of clinical benefit for immunosuppressed patients with serious CMV infections. For bone marrow transplant recipients, ganciclovir may be more effective when used prophylactically or earlier in the course of CMV infection before the development of pneumonia.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Moxalactam for treatment of nosocomial infections.

Sixty-five episodes of nosocomial infections of the blood, lungs, urinary tract, soft tissues, bones, or central nervous system were treated with intravenous moxalactam (3-12 g per day). Bacteremia was documented in 21 patients. Despite the severely compromised condition of many patients, 80% of the infections responded satisfactorily, as defined by clinical and microbiologic cure or improvement. Of the 21 cases of nosocomial bacteremia, 14 (67%) responded satisfactorily. Of the six cases of bacteremia caused by gram-negative bacilli resistant to aminoglycosides, three responded satisfactorily. Moxalactam therapy also resulted in cure or improvement in nine (69%) of 13 pulmonary infections, and it was used alone to cure one case of meningitis-ventriculitis due to Klebsiella pneumoniae. Seven of 13 therapeutic failures involved Pseudomonas aeruginosa, and moxalactam-resistant P. aeruginosa emerged during therapy for 12 patients. Adverse effects, usually mild diarrhea, occurred in 9.2% of the patients. Except for some severe infections due to P. aeruginosa, moxalactam is effective and safe therapy for nosocomial infections caused by susceptible organisms.

Cephalosporins↗
PubMedDate not supplied

Moxalactam in the treatment of intraabdominal sepsis and other surgical infections.

Bacterial peritonitis, intraabdominal sepsis, and other surgical infections are frequently polymicrobial. Moxalactam, a new beta-lactam antibiotic, has been shown to be active in vitro against most bacterial pathogens commonly isolated from patients with surgical infections. This drug was therefore tested as the sole antimicrobial agent in the treatment of 32 surgical infections (25 cases of intraabdominal sepsis, 6 cases of wound infections, and 1 case of bacteremia). Nearly all (91%) of the infections responded favorably; 66% were cured with moxalactam plus surgery, 16% were cured with moxalactam alone, and 9% improved. Moxalactam-resistant strains of bacteria were isolated from 18 infections but were associated with therapeutic failure in only two cases and with superinfection in three cases. On the basis of these data, we believe that moxalactam is an effective and safe antimicrobial agent for use alone in the treatment of serious intraabdominal infections.

Abdomen↗