ABSTRACT
The aim of this multicentered, prospective and open study was to determine the clinical and bacteriological efficacy and safety of piperacillin/tazobactam (4g/500 mg IV tid) in the treatment of 79 adult patients with complicated urinary tract infections (UTI) requiring hospitalization. Forty-seven women and 32 men (mean age 54.2 years, and range 21-91) from 4 Argentinean and 6 Mexican hospitals were enrolled. Sixty-one clinically and bacteriologically evaluable patients were treated for a mean of 9.1 days (range 5-15). A favorable clinical response was seen in 83.6% and 80% at early and late assessment, respectively. Bacteriological eradication was achieved in 85.3% and 80% at early and late estimation, respectively. Escherichia coli was isolated in 33 cases, Klebsiella pneumoniae in 8, Enterococcus spp. in 7, Proteus mirabilis in 6, Pseudomonas aeruginosa in 3, Enterobacter spp. and Morganella morganii in 2. While 21% of all the clinical isolates were resistant to piperacillin, none of them was initially resistant to piperacillin/tazobactam. However, one female patient with a persistent UTI caused by E. coli developed resistance to piperacillin/tazobactam during treatment. A 64-year-old man with frontal meningioma developed purulent meningitis due to Enterobacter cloacae after neurosurgery. He was initially treated with ciprofloxacin, rifampin and amikacin and because of persistence of fever, he was moved to piperacillin/tazobactam. After 5 days of therapy, he developed coma secondary to intracranial hemorrhage and died. By then, the platelet count was normal (220,000/microliters), but the prothrombin time (19.5 seconds) and the partial thromboplastin time (63 seconds) were significantly prolonged. Our data suggest that piperacillin/tazobactam is a reliable therapy for complicated, non-complicated, community or hospital-acquired UTI.
Subject(s)
Drug Therapy, Combination/therapeutic use , Urinary Tract Infections/drug therapy , Adult , Aged , Aged, 80 and over , Drug Resistance, Microbial , Female , Humans , Male , Middle Aged , Penicillanic Acid/adverse effects , Penicillanic Acid/analogs & derivatives , Penicillanic Acid/therapeutic use , Piperacillin/adverse effects , Piperacillin/therapeutic use , Piperacillin, Tazobactam Drug Combination , Prospective Studies , Treatment OutcomeABSTRACT
El presente trabajo prospectivo ha tenido como objetivo la disminución de la incidencia de infección intrahospitalaria en un área de Terapia Intensiva de la M.C.B.A., a través del estudio de la cadena epidemiológica, la identificación de los factores de riesgo, la elaboración de normas de control y la formación de recursos humanos. Se efectuó el seguimiento longitudinal durante ocho meses y posteriormente en forma inmediata se pasó a desarrollar el programa de Control de Infecciones. Los resultados obtenidos a los ocho meses de aplicación han sido altamente satisfactorios y nos impulsaron a darlos a conocer, aunque para una programación de éste tipo la evaluación pueda ser considerada prematura (AU)
Subject(s)
Humans , Comparative Study , Cross Infection , Follow-Up Studies , Intensive Care Units , Risk Factors , Health Programs and Plans , Outcome Assessment, Health Care , Cross Infection/epidemiology , Cross Infection/prevention & controlABSTRACT
El presente trabajo prospectivo ha tenido como objetivo la disminución de la incidencia de infección intrahospitalaria en un área de Terapia Intensiva de la M.C.B.A., a través del estudio de la cadena epidemiológica, la identificación de los factores de riesgo, la elaboración de normas de control y la formación de recursos humanos. Se efectuó el seguimiento longitudinal durante ocho meses y posteriormente en forma inmediata se pasó a desarrollar el programa de Control de Infecciones. Los resultados obtenidos a los ocho meses de aplicación han sido altamente satisfactorios y nos impulsaron a darlos a conocer, aunque para una programación de éste tipo la evaluación pueda ser considerada prematura
Subject(s)
Humans , Cross Infection , Follow-Up Studies , Health Programs and Plans , Cross Infection/epidemiology , Cross Infection/prevention & control , Intensive Care Units , Outcome Assessment, Health Care , Risk FactorsABSTRACT
Se analizaron restrospectivamente 53 casos de tétanos del adulto admitidos en la sala de terapia intensiva entre los años 1986 y 1987. Cerca de la mitad de los ingresos (47 por ciento) tuvieron el antecedente de la aplicación de inyectables por vía intramuscular. La mortalidad de ese grupo fue del 84 por ciento vs. el 33 por ciento del grupo asociado a heridas. El período de incubación en 22 de 25 pacientes fue menor de 5 días, con generalización de los síntomas en las 24 horas siguientes a la aparición del trismus. Esta evolución se observó en 5 de 21 pacientes con antecedentes de heridas. Se advierte sobre el aumento de la enfermedad asociada a inyecciones IM y la identificación de un grupo de alto riesgo en quienes se recomienda asegurar la correcta inmunización previo a la terapeútica por esa vía de administración (AU)
Subject(s)
Comparative Study , Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Tetanus/classification , Tetanus/complications , Tetanus/epidemiology , Intensive Care Units/statistics & numerical dataABSTRACT
Se analizaron restrospectivamente 53 casos de tétanos del adulto admitidos en la sala de terapia intensiva entre los años 1986 y 1987. Cerca de la mitad de los ingresos (47 por ciento) tuvieron el antecedente de la aplicación de inyectables por vía intramuscular. La mortalidad de ese grupo fue del 84 por ciento vs. el 33 por ciento del grupo asociado a heridas. El período de incubación en 22 de 25 pacientes fue menor de 5 días, con generalización de los síntomas en las 24 horas siguientes a la aparición del trismus. Esta evolución se observó en 5 de 21 pacientes con antecedentes de heridas. Se advierte sobre el aumento de la enfermedad asociada a inyecciones IM y la identificación de un grupo de alto riesgo en quienes se recomienda asegurar la correcta inmunización previo a la terapeútica por esa vía de administración
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Tetanus/classification , Intensive Care Units/statistics & numerical data , Tetanus/complications , Tetanus/epidemiologyABSTRACT
The effects of cytarabine on neurological forms of Argentina Hemorrhagic Fever were evaluated in 125 patients. The mortality was 12.88 per cent compared to 61.40 per cent in untreated patients. (p less than 0.0001). The efficiency of this treatment depends on its early application. No side effect was observed.
Subject(s)
Cytarabine/therapeutic use , Encephalitis, Arbovirus/drug therapy , Hemorrhagic Fever, American/complications , Adult , Aged , Encephalitis, Arbovirus/blood , Encephalitis, Arbovirus/etiology , Humans , Middle Aged , Nervous System Diseases/drug therapy , Nervous System Diseases/etiology , Time FactorsABSTRACT
During the 23 consecutive annual epidemics of Argentine haemorrhagic fever observed from 1959 to 1983, a group of 4,433 patients were treated at Junin (Argentina) with convalescent's plasma; the overall mortality rate was 3.29%. In 1958, before convalescent's plasma was used, the mortality rate in 448 patients who received the conventional treatment was 42.85%. The difference between the two groups is highly significant and demonstrates the value of convalescent's plasma in the treatment of the disease.
Subject(s)
Hemorrhagic Fever, American/therapy , Immunotherapy/methods , Plasma , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Hemorrhagic Fever, American/diagnosis , Hemorrhagic Fever, American/mortality , Humans , Infant , Male , Middle AgedABSTRACT
Adult patients with severe bacterial infections caused by organisms susceptible to imipenem and cefotaxime were given either imipenem/cilastatin sodium (MK0787/MK0791) or cefotaxime as a part of a multiclinic randomized study to evaluate the effectiveness, safety, and tolerability of imipenem/cilastatin. Clinical diagnoses included bacteremia, urinary tract infection, osteomyelitis, mediastinitis, lower respiratory tract infection, and soft tissue infection. Efficacy was evaluated for 10 patients given imipenem/cilastatin and for 10 patients given cefotaxime. Major pathogens isolated included Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Klebsiella species, Streptococcus pneumoniae, Bacteroides fragilis, and Peptostreptococcus species. Satisfactory clinical responses were noted in 90% of the patients in both treatment groups. Eradication of the pathogen was achieved in nine of 10 patients treated with imipenem/cilastatin and in 10 of 10 patients treated with cefotaxime. No major adverse effects were found in patients in each treatment group. The results of this study suggest that imipenem/cilastatin sodium is a relatively safe and effective antibiotic for the treatment of adult patients with severe infections caused by susceptible organisms.
