Treatment of complicated urinary tract infections with lomefloxacin compared with that with trimethoprim-sulfamethoxazole.

The efficacy of lomefloxacin given at 400 mg once daily for 14 days compared with that of trimethoprim-sulfamethoxazole at 160 and 800 mg, respectively, given twice daily for 14 days in the treatment of symptomatic complicated urinary tract infections was studied in a prospective, randomized, single-blind multicenter study. A total of 133 subjects presenting with signs and symptoms of urinary tract infection and an underlying abnormality consistent with complicated urinary tract infection were enrolled in the study. Bacteriologic cure was significantly better in 68 subjects randomized to lomefloxacin than in 65 subjects randomized to trimethoprim-sulfamethoxazole at short-term follow-up (88 versus 52%; 95% confidence intervals [CIs] 77 and 94% and 39 and 65%, respectively) this difference was no longer significant at long-term follow-up (64 versus 47%; CIs, 52 and 75% and 32 and 57%, respectively). Clinical outcomes were similar for both therapeutic regimens at short- and long-term follow-ups. The organisms that infected the subjects pretherapy were more frequently resistant to trimethoprim-sulfamethoxazole, and drug therapy was discontinued more frequently in subjects treated with trimethoprim-sulfamethoxazole because of adverse antimicrobial effects. In secondary analyses, outcomes did not differ with age or underlying genitourinary abnormality.(ABSTRACT TRUNCATED AT 250 WORDS)

Infective endocarditis due to Eikenella corrodens: Case report and review of the literature.

Eikenella corrodens is an uncommon cause of bacterial endocarditis. In the 11 reported cases in the literature, the disease was associated with predisposing factors and was clinically indolent or subacute. A case is reported which in contrast to the reported literature was acute in onset with severe heart failure, requiring urgent valve replacement.

The Lemierre syndrome: suppurative thrombophlebitis of the internal jugular vein secondary to oropharyngeal infection.

We present 2 cases of the Lemierre syndrome (also called postanginal septicemia), along with 36 other cases from a review of recent literature. A review of the literature during the preantibiotic era is also included. This disease is caused by an acute oropharyngeal infection with secondary thrombophlebitis of the internal jugular vein complicated by multiple metastatic infection. The majority of cases are caused by anaerobic gram-negative organisms, most frequently Fusobacterium necrophorum. An enhanced computed tomographic scan of the neck is the technique of choice to demonstrate the thrombosis of the internal jugular vein. Prolonged intravenous administration of antimicrobial agents known to have a good antianaerobic coverage, along with drainage of purulent collections, will usually be successful in the overwhelming majority of patients.

Infective endocarditis caused by Neisseria flavescens.

Neisseria flavescens is a rare cause of human disease. This is the first reported case of endocarditis caused by N. flavescens. The organism produced beta-lactamase, and penicillin therapy failed to cure the infection. Therapy with cefotaxime, to which the organism was highly sensitive, led to a complete and uneventful recovery.