Tags: Gentamicin Sulfate

Other Gram-Positive Cocci

VIRIDANS GROUP STREPTOCOCCI, INCLUDING ABIOTROPHIA DEFECTIVA & ABIOTROPHIA ADJACENS Essentials of Diagnosis • Facultatively anaerobic gram-positive cocci, catalase negative, coagulase negative. • a or ? hemolytic on blood agar. • Abiotrophia defectiva and Abiotrophia adjacens require pyridoxal or thiol group supplementation. • Streptococcus milleri group organisms often exhibit Lancefield antigens A, C, F, or G and often have a butterscotch odor. General Considerations A. Epidemiology. Viridans streptococci are part of the normal microbial flora of humans and animals and are indigenous to the upper respiratory tract, the female genital tract, all regions of the gastrointestinal tract, and, most significantly, the oral cavity. Clinically significant species that are currently recognized as belonging …

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Evaluation of therapeutic outcomes

The evaluation of patients treated for Infective endocarditis includes assessment of signs and symptoms, blood cultures, microbiologic tests (e.g., minimum inhibitory concentration, minimum bactericidal concentration, or serum bactericidal titers), serum drug concentrations, and other tests to evaluate organ function. Persistence of fever may indicate ineffective antimicrobial therapy, emboli, infections of intravascular catheters, or a drug reaction. In some patients, low-grade fever may persist even with appropriate antimicrobial therapy. With effective therapy, blood cultures should be negative within a few days, although microbiological response to vancomycin may be unusually slower. TABLE. Treatment of Staphylococcal Endocarditis in the Presence of a Prosthetic Valve or Other Prosthetic Materiala Antibiotic Dosage and Route Duration (wks) …

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Antimicrobial therapy: general principles

A wide variety of antimicrobial agents is available to treat established infections caused by bacteria, fungi, viruses, or parasites. This section will cover the general principles of antimicrobial therapy and will also include illustrative clinical problems to emphasize proper decision-making in using antimicrobials. Determinants of Antimicrobial Efficacy Measurement of antimicrobial activity in vitro Susceptibility testing is indicated for any bacterial pathogen warranting chemotherapy. Drugs that irreversibly destroy the ability of an organism to replicate, and perhaps in the process destroy the structural integrity of the organism, are microbicidal. Drugs that reversibly impair replicating ability, with this function being restored when drug concentrations fall below critical inhibitory levels, are microbiostatic. In quantitative …

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Toxicity of Antimicrobial Therapy

Mechanisms of toxicity The mechanisms associated with common adverse reactions to antimicrobials include dose-related toxicity that occurs in a certain fraction of patients when a critical plasma concentration or total dose is exceeded, and toxicity that is unpredictable and mediated through allergic or idiosyncratic mechanisms. For example, certain classes of drugs such as the aminoglycosides are associated with dose-related toxicity. In contrast, the major toxicity of the penicillins and cephalosporins is due to allergic reactions. These differences are explained in part by the relative ability of specific drugs to inhibit enzymatic pathways in the host versus their stimulation of specific immune response. Not included in these lists is mention of the …

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Management of Bacterial Meningitis

Central nervous system infections, especially bacterial meningitis, are frequently life-threatening and usually constitute medical emergencies that require accurate and prompt treatment. (Portions of this section about meningitis have previously been published [Swartz and O'Hanley 1987] and are reproduced with permission of the publisher, Scientific American Medicine, New York. [Send permission to section editor.]) Fortunately, advances in methods of diagnosis and treatment developed during the past 15 years have significantly improved the prognosis associated with many of these illnesses. New diagnostic methods (such as latex agglutination and polymerase chain reaction) supplement rather than supplant cerebrospinal fluid studies. The cerebrospinal fluid studies frequently provide important initial information needed for clinical and microbiologic diagnosis; …

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Management of Infective Endocarditis

Epidemiology Infective endocarditis is a microbial infection of the endothelial lining of the heart. The characteristic lesion is a vegetation (a mass comprised of fibrin, platelets, microorganisms and their product or products on a valve leaflet). Multiple valves may be involved, as may any part of the endothelium of the heart. The incidence of endocarditis ranges from 17 to 39 cases per million person-years. There have been major changes in the epidemiology of endocarditis. The age of patients affected has increased considerably. In 1945, about 10% of patients with Infective endocarditis were over 60 years of age (Lerner and Weinstein 1966), compared with 55% in 1977. The second major change in …

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Management of Sepsis

Definition and prognosis Sepsis, sepsis syndrome, septic shock, and multiorgan dysfunction are all part of a continuum of infection-related systemic illness. Table Definitions for Sepsis, Sepsis Syndrome, Septic Shock and Multiorgan Dysfunction Syndrome gives definitions for each of these entities. The pathogenesis of sepsis is very complex, involving a large number of mediators. A cascade is started when endotoxin or other products of microorganisms enter the circulation, resulting in the release of a variety of mediators from mononuclear phagocytes, endothelial cells and other cells. Initially the proinflammatory cytokines (tumor necrosis factor, IL-1β, IL-6, and IL-8) are elevated, although there are large individual variations. The anti-inflammatory cytokines (IL-10) and soluble cytokine receptors …

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Order Clindamycin (Cleocin) No Prescription 150/300mg

Clindamycin Hydrochloride, Clindamycin Palmitate Hydrochloride, Clindamycin Phosphate • Clindaymcin is a semisynthetic antibiotic that is a derivative of lincomycin. Spectrum Clindamycin is active against most aerobic gram-positive cocci including staphylococci, Streptococcus pneumoniae, and other streptococci (except Enterococcus faecalis [formerly S. faecalis]). The drug also is active in vitro against Arcanobacterium haemolyticum (formerly Corynebacterium haemolyticum). Clindamycin is active against some anaerobic and microaerophilic gram-negative and gram-positive organisms including Actinomyces, Bacteroides, Eubacterium, Fusobacterium, Propionibacterium, microaerophilic streptococci, Peptococcus, Peptostreptococcus, and Veillonella. Clindamycin is active in vitro against Prevotella and Porphyromonas (both formerly classified as Bacteroides); Mobiluncus (motile, anaerobic, curved rods) also are inhibited in vitro by the drug. Clostridium perfringens, C. tetani, Corynebacterium diphtheriae, …

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Order Cleocin (Clindamycin) No Prescription 150/300mg

Clindamycin Hydrochloride, Clindamycin Palmitate Hydrochloride, Clindamycin Phosphate: Dosage and Administration • Reconstitution and Administration Clindamycin hydrochloride and clindamycin palmitate hydrochloride are administered orally. Clindamycin phosphate is administered by IM injection or by intermittent or continuous IV infusion. • Oral Administration Clindamycin hydrochloride capsules and clindamycin palmitate hydrochloride oral solution can be administered without regard to food. To avoid the possibility of esophageal irritation, clindamycin hydrochloride capsules should be administered orally with a full glass of water. Clindamycin palmitate hydrochloride oral solution is reconstituted by adding 75 mL of water to the 100-mL bottle; a large portion of the 75 mL should be added initially and the bottle shaken vigorously, and then …

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Aminoglycosides: Amikacin, Gentamicin, Kanamycin, or Tobramycin

Amikacin Sulfate, Gentamicin Sulfate, Kanamycin Sulfate, Neomycin Sulfate, Paromomycin Sulfate, Streptomycin Sulfate, Tobramycin Sulfate • Aminoglycosides are antibiotics that generally are active against many aerobic gram-negative bacteria and some aerobic gram-positive bacteria and principally are used for serious infections. Uses • Parenteral Amikacin, gentamicin, kanamycin, or tobramycin is used IM or IV in the short-term treatment of serious infections such as septicemia (including neonatal sepsis), bone and joint infections, skin and soft tissue infections (including those resulting from burns), respiratory tract infections, and postoperative and intra-abdominal infections (including peritonitis) caused by susceptible strains of gram-negative bacteria. The drugs also are effective in serious, complicated, recurrent urinary tract infections caused by susceptible …

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