ABSTRACT
In this study, the efficacy of ceftaroline fosamil was compared with that of cefepime in an experimental rabbit meningitis model against two Gram-negative strains (Escherichia coli QK-9 and Klebsiella pneumoniae 1173687). The penetration of ceftaroline into inflamed and uninflamed meninges was also investigated. Both regimens were bactericidal, but ceftaroline fosamil was significantly superior to cefepime against K. pneumoniae and E. coli in this experimental rabbit meningitis model (P < 0.0007 against K. pneumoniae and P < 0.0016 against E. coli). The penetration of ceftaroline was approximately 15% into inflamed meninges and approximately 3% into uninflamed meninges.
Subject(s)
Anti-Bacterial Agents/pharmacology , Cephalosporins/pharmacology , Klebsiella Infections/drug therapy , Meningitis, Escherichia coli/drug therapy , Animals , Anti-Bacterial Agents/cerebrospinal fluid , Anti-Bacterial Agents/pharmacokinetics , Cefepime , Cephalosporins/cerebrospinal fluid , Cephalosporins/pharmacokinetics , Disease Models, Animal , Escherichia coli/drug effects , Escherichia coli/physiology , Klebsiella Infections/cerebrospinal fluid , Klebsiella Infections/microbiology , Klebsiella pneumoniae/drug effects , Klebsiella pneumoniae/physiology , Meninges/drug effects , Meninges/metabolism , Meninges/microbiology , Meningitis, Escherichia coli/cerebrospinal fluid , Meningitis, Escherichia coli/microbiology , Permeability , Rabbits , Treatment Outcome , CeftarolineABSTRACT
Ceftaroline is a new cephalosporin with bactericidal activity against resistant Gram-positive organisms, including methicillin-resistant Staphylococcus aureus (MRSA) and penicillin-resistant Streptococcus pneumoniae, as well as common Gram-negative organisms. This study tested the prodrug, ceftaroline fosamil, against a penicillin-sensitive and a penicillin-resistant strain of S. pneumoniae in an experimental rabbit meningitis model. The penetration of ceftaroline into inflamed meninges was approximately 14%. Ceftaroline fosamil was slightly superior to ceftriaxone against the penicillin-sensitive strain and significantly superior to the combination of ceftriaxone and vancomycin against the penicillin-resistant strain.
Subject(s)
Anti-Bacterial Agents/pharmacology , Cephalosporins/therapeutic use , Meningitis/drug therapy , Penicillins/pharmacology , Streptococcus pneumoniae/pathogenicity , Animals , Penicillin Resistance , Rabbits , Streptococcus pneumoniae/drug effects , CeftarolineABSTRACT
We report the case of a 28-years-old woman with Turner's syndrome and iron deficiency anaemia. The faecal occult blood test was intermittently positive whereas earlier upper and lower endoscopy revealed no source of bleeding. Capsule endoscopy showed multiple vascular malformations on the jejunum and ileum. Our case report emphasizes the importance of capsule endoscopy in the localising occult bleedings in the small bowel. We discuss the different diagnostic modalities and possible treatments.
Subject(s)
Anemia, Iron-Deficiency/etiology , Gastrointestinal Hemorrhage/diagnosis , Turner Syndrome/diagnosis , Adult , Anemia, Iron-Deficiency/diagnosis , Anemia, Iron-Deficiency/genetics , Capsule Endoscopy , Diagnosis, Differential , Dilatation, Pathologic/diagnosis , Female , Gastrointestinal Hemorrhage/genetics , Hemangioma/diagnosis , Humans , Ileum/blood supply , Jejunum/blood supply , Telangiectasis/diagnosis , Turner Syndrome/genetics , Veins/pathologyABSTRACT
We report the case of a 58-years-old soldier with a history of movement related neck pain, weight loss and exercise intolerance. Blood tests presented signs of an inflammatory syndrome. The CT-scan showed extended thickening of the aortic wall characteristic for aortitis. The diagnosis of giant cell arteritis could be histologically confirmed by biopsy of the temporal arteries. Our case report emphasizes the importance of the various imaging modalities. We discuss the different forms of disease evolution and the treatment regimen.
Subject(s)
Fatigue/etiology , Giant Cell Arteritis/diagnosis , Military Personnel , Weight Loss , Aortitis/diagnosis , Aortitis/pathology , Biopsy , Giant Cell Arteritis/pathology , Humans , Male , Middle Aged , Temporal Arteries/pathologyABSTRACT
Ceftobiprole medocaril, a new cephalosporin, is highly active against a broad spectrum of Gram-positive and Gram-negative clinical pathogens, including methicillin-resistant Staphylococcus aureus (MRSA) and penicillin-resistant pneumococci. In this study, we tested ceftobiprole against various Gram-negative pathogens in a rabbit meningitis model and determined its penetration into the cerebrospinal fluid (CSF). In this animal model, ceftobiprole produced an antibacterial activity similar to that of cefepime against an Escherichia coli strain, a Klebsiella pneumoniae strain, and a ß-lactamase-negative Haemophilus influenzae strain. Against a ß-lactamase-positive H. influenzae strain, ceftobiprole was significantly superior. The penetration of ceftobiprole through inflamed meninges reached about 16% of serum levels compared to about 2% of serum levels through uninflamed meninges.
Subject(s)
Anti-Bacterial Agents/administration & dosage , Cephalosporins/administration & dosage , Disease Models, Animal , Gram-Negative Bacteria/drug effects , Meningitis, Bacterial/drug therapy , beta-Lactamases/metabolism , Animals , Anti-Bacterial Agents/blood , Anti-Bacterial Agents/cerebrospinal fluid , Cephalosporins/blood , Cephalosporins/cerebrospinal fluid , Escherichia coli/drug effects , Escherichia coli/enzymology , Gram-Negative Bacteria/enzymology , Gram-Negative Bacterial Infections/drug therapy , Gram-Negative Bacterial Infections/microbiology , Haemophilus influenzae/drug effects , Haemophilus influenzae/enzymology , Klebsiella pneumoniae/drug effects , Klebsiella pneumoniae/enzymology , Meningitis, Bacterial/microbiology , Microbial Sensitivity Tests , Rabbits , Treatment OutcomeABSTRACT
We examined the cerebrospinal fluid penetration of daptomycin after the addition of dexamethasone and its bactericidal efficacy with and without ceftriaxone in an experimental rabbit model of pneumococcal meningitis. The combination of daptomycin with ceftriaxone was the most efficacious regimen for pneumococcal meningitis. The previous addition of dexamethasone affected the antibacterial activity of daptomycin only marginally, either as monotherapy or combined with ceftriaxone, although the penetration of daptomycin into inflamed meninges was significantly reduced from 6 to 2%. Daptomycin with ceftriaxone might be a potential candidate for the empirical therapy of bacterial meningitis, although the activity of this regimen against Listeria monocytogenes remains to be demonstrated.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Ceftriaxone/therapeutic use , Daptomycin/therapeutic use , Dexamethasone/therapeutic use , Meningitis, Bacterial/drug therapy , Vancomycin/therapeutic use , Animals , Chromatography, High Pressure Liquid , Drug Therapy, Combination , RabbitsSubject(s)
Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Aspirin/adverse effects , Colonic Diseases/chemically induced , Diclofenac/adverse effects , Intestinal Obstruction/chemically induced , Ulcer/chemically induced , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Aspirin/therapeutic use , Colonic Diseases/diagnosis , Diagnosis, Differential , Diclofenac/therapeutic use , Drug Therapy, Combination , Female , Humans , Intestinal Obstruction/diagnosis , Middle Aged , Ulcer/diagnosisABSTRACT
From medical view the main problems of investigation and convicts are in particular in the range of the drugs and alcohol illnesses to see transferable diseases (HIV, hepatitis B - C and tuberculosis) and psychological illnesses. These complex diseases require a close meshed and intensive support of each individual patient and represent actually the main problem during an arrest. The development of the health service could address the new requirements making possible cost-conscious acting in handling with resources in the health service. In the canton Berne 957197 inhabitants live on a total area of 5959 km2. The police and military management operates the regional and district prisons as well as the transportation service for prisoners in the canton Berne for prisoners. The canton Berne has altogether 327 places. Since May 1971 persons from the regional and district prison and the penal institutions needing hospitalisation can be accepted. In the University hospital Berne on a specially equipped guard station and be cared for their medical problems. The prisoners profit in such a way from the entire range of the university facilities.
Subject(s)
Delivery of Health Care/organization & administration , Health Services Accessibility/organization & administration , Prisoners/statistics & numerical data , Prisons , Ambulatory Care/organization & administration , Ambulatory Care/statistics & numerical data , Communicable Disease Control/organization & administration , Comorbidity , Cross-Sectional Studies , Delivery of Health Care/statistics & numerical data , Female , HIV Infections/epidemiology , Health Services Accessibility/statistics & numerical data , Hepatitis B/epidemiology , Hepatitis C/epidemiology , Hospitalization/statistics & numerical data , Hospitals, University/organization & administration , Hospitals, University/statistics & numerical data , Humans , Male , Mental Disorders/epidemiology , Security Measures/organization & administration , Substance-Related Disorders/epidemiology , SwitzerlandSubject(s)
Hypercalcemia/diagnosis , Hyperparathyroidism, Primary/diagnosis , Hypertension/etiology , Aged , Animals , Diagnosis, Differential , Disease Models, Animal , Female , Goiter, Nodular/diagnosis , Goiter, Nodular/surgery , Humans , Hypercalcemia/complications , Hyperparathyroidism, Primary/complications , Osteoporosis/diagnosis , Thyroidectomy , Treatment OutcomeABSTRACT
Daptomycin monotherapy was superior to ceftriaxone monotherapy and was highly efficacious in experimental pneumococcal meningitis, sterilizing the cerebrospinal fluid (CSF) of three of three rabbits after 4 to 6 h. With daptomycin therapy only a negligible release of [(3)H]choline as marker of cell wall lysis was detectable in the CSF, peaking around 250 cpm/min after 4 h, compared to a peak of around 2,400 cpm/min after 4 to 6 h for the ceftriaxone-treated rabbits.
