Piperacillin/tazobactam in the treatment of hospitalized patients with urinary tract infections: an open non-comparative and multicentered trial.

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.

Comparison of the safety and efficacy of lomefloxacin and amoxicillin in the treatment of acute exacerbations of chronic bronchitis: Results from a Latin American multicenter study.

The aim of this study was to compare the safety and efficacy of lomefloxacin, a new difluornated quinolone, with those of amoxicillin in the treatment of acute exacerbations of chronic bronchitis caused by Gram-negative bacteria. The study was conducted as a multicenter, randomized, single-blind comparison in four countries (Argentina, Colombia, Mexico and Venezuela). In total, 163 evaluable patients were assessed-82 in the lomefloxacin group and 81 in the amoxicillin group. Patients received oral therapy with either 40 mg lomefloxacin once daily or 500 mg amoxicillin three times daily for 10 days. The most frequent bacterial pathogens isolated included: Haemophilus influenzae, Moraxella catarrhalis, Pseudomonas aeruginosa and Klebsiella pneumoniae. The overall clinical success rates (cure plus improvement) were 93.9% in the lomefloxacin group and 81.5% in the amoxicillin group. The eradication rate was 81.7% in the lomefloxacin group and 75.3% in the amoxicillin group. Most of the clinical and bacteriological failures in both groups were associated with P. aeruginosa in baseline sputum cultures. In conclusion, once-daily lomefloxacin is a safe and effective treatment for acute exacerbations of chronic bronchitis caused by Gram-negative pathogens.

Evaluacion de augmentin en el tratamiento de infecciones bacterianas en pacientes pediatricos. / Evaluation of augmentin in the treatment of bacterial infeccions in pediatric patients

Se presentan los resultados de un estudio abierto, para evaluar la eficacia y seguridad de augmentin en diversas infecciones bacterianas de poblacion pediatrica. El producto se pescribio a dosis de 312.5 mg cada 8 horas en forma de tabletas solubles La edad de los pacientes oscilo entre 3 y 12 anos; el 74% curso con infeccion respiratoria o de sus anexos: las bacterias mas frecuentemente aisladas fueron:Streptococcus pyogenes (8).Staphylococcus aureus (7) y Streptococcus pneumoniae (6). La fiebre se abatio dentro de las primeras 72 horas en el 80% de los casos.De los 30 pacientes 27 fueron evaluados, de los cuales hubo curacion completa clinica y bacteriologica en 24 (89%), 3 pacientes se consideraron como fracaso. Los efectos secundarios encontrados fueron de tipo gastrointestinal

Evaluacion de augmentin en el tratamiento de infecciones bacterianas en pacientes pediatricos. / Evaluation of augmentin in the treatment of bacterial infections in pediatric patients

Se presentan los resultados obtenidos con la valoracion de augmentin en 30 pacientes pediatricos portadores de infeccion bacteriana en tracto respiratorio alto y bajo, asi como en tracto urinario, usando la dosificacion de 312.5 mg cada 12 horas. El augmentin, que posee accion bactericida e inhibitoria de betalactamasa, fue muy eficaz en infecciones producidas por Staphylococcus aureus, que mostrara resistencia a la cefalotina y a la ampicilina. Del grupo de 30 pacientes, 27 fueron evaluables; de estos, se considero exito en 24, que representaron el 89% y 3 fracasos con patologia que favorecia la permanencia de la infeccion. La tolerancia fue satisfactoria; en los pacientes que presentaron efectos colaterales, estos fueron menores, de tipo gastroenterico y no hubo necesidad de suspender la medicacion. En conclusion, la administracion de augmentin cada 12 horas da los mismos resultados de exito terapeutico que la dosis cada 8 horas, pero con menor incidencia de efectos coraterales

Revaloracion clinica, bacteriologica de la lincomicina en infecciones del tracto respiratorio inferior. / Clinical and bacteriological reevaluation of lincomycin in low respiratory tract infections

Se estudiaron 40 pacientes hospitalizados afectados por infecciones del tracto respiratorio inferior. A todos los pacientes se les administraron 600 mg de lincomicina I.V. o I.M. cada ocho horas, durante cinco dias,continuandose con 500 mg por via oral, cada seis horas, por cinco dias mas. Se determino la CMI de lincomicina en todos los germenes patogenos aislados. En ocho pacientes, se midieron los niveles sericos obtenidos con el antibiotico por las diferentes vias de administracion. La respuesta clinica fue satisfactoria, ya que en los 33 casos en que se cultivaron germenes grampositivos hubo curacion y erradicacion del agente infeccioso.Los efectos colaterales fueron dos, uno de ellos presento flebitis y el otro evacuaciones pastosas. En ninguno hubo necesidad de suspender el tratamiento antimicrobiano