The Journal of antimicrobial chemotherapy
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J. Antimicrob. Chemother. · May 2005
Comparative StudyNurse-led management of uncomplicated cellulitis in the community: evaluation of a protocol incorporating intravenous ceftriaxone.
A management protocol for specialist nurses was developed for ambulatory management of uncomplicated cellulitis requiring initial intravenous (i.v.) antibiotic therapy. Patients were all managed through an outpatient parenteral antibiotic therapy (OPAT) service. Those with cellulitis were compared pre- and post-intervention. ⋯ Specialist nurse-led management is safe and effective in the management of uncomplicated cellulitis in the context of an OPAT service and reduces the need for regular medical review without compromising clinical care.
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J. Antimicrob. Chemother. · Jan 2005
Experimental study of teicoplanin, alone and in combination, in the therapy of cephalosporin-resistant pneumococcal meningitis.
The aim of the study was to determine the efficacy of teicoplanin, alone and in combination with ceftriaxone, in a rabbit model of cephalosporin-resistant pneumococcal meningitis, and to assess the effect of concomitant therapy with dexamethasone. ⋯ Teicoplanin alone was very effective in this model of cephalosporin-resistant pneumococcal meningitis. The use of concomitant dexamethasone resulted in lower CSF teicoplanin levels, but not in therapeutic failures. The combination of teicoplanin plus ceftriaxone and dexamethasone might be a good alternative for the empirical therapy of pneumococcal meningitis. Additional data should confirm our experiments, in advance of clinical trials to assess efficacy in humans.
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J. Antimicrob. Chemother. · Jan 2005
ReviewAnti-inflammatory effects of macrolides--an underappreciated benefit in the treatment of community-acquired respiratory tract infections and chronic inflammatory pulmonary conditions?
It has been recognized for more than 20 years that the macrolides have immunomodulatory effects that are beneficial for those suffering from chronic pulmonary inflammatory syndromes, such as diffuse panbronchiolitis, cystic fibrosis, asthma and bronchiectasis. The macrolides have consistently been associated with decreased length of stay and mortality when used alone or in combination with beta-lactam antibiotics. This effect can be demonstrated against combinations consisting of beta-lactams and other antibiotics active against 'atypical chest pathogens' when treating community-acquired pneumonia (CAP) in hospitalized patients. As such, it appears that the macrolides' effects in CAP patients are more than just antibacterial in nature. AIMS OF THIS REVIEW: This review aims: to give the reader information on the background areas described, as well as related areas; to review the CAP benefits with macrolides and how they may be related to the immunomodulatory properties they demonstrate, albeit in a shorter period of time than previously demonstrated with chronic pulmonary disorders; to use ex vivo data to support these extrapolations. ⋯ (1) Research into macrolide immunomodulation for chronic pulmonary disorders demonstrates consistent positive effects, although of types other than seen with diffuse panbronchiolitis. These effects, together with their inhibitory activity on biofilms, have the potential to make them a useful option. (2) The benefits for CAP are consistent, and higher when a macrolide is given with another atypical agent than if the other atypical agent is given alone, suggesting a non-antibacterial benefit. (3) Recent research of the immunomodulatory properties of azithromycin imply that azithromycin may have a previously unknown short-term biphasic effect on inflammation modulation: enhancement of host defence mechanisms shortly after initial administration followed by curtailment of local infection/inflammation in the following period. (4) Additional in vivo research is needed prior to developing any firm conclusions.
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J. Antimicrob. Chemother. · Jan 2005
A rapid method of impregnating endotracheal tubes and urinary catheters with gendine: a novel antiseptic agent.
To test the efficacy of gendine, a novel antiseptic, containing Gentian Violet and chlorhexidine, in coating different medical devices, including endotracheal tubes (ETT) and urinary catheters (UC). ⋯ GND-ETT and GND-UC impregnated using an instantaneous dip method, were shown to have broad-spectrum activity, prolonged antimicrobial durability and high efficacy in inhibiting adherence of organisms commonly causing nosocomial pneumonia and urinary tract infection. Furthermore, these coated devices were shown to be non-cytotoxic.
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J. Antimicrob. Chemother. · Dec 2004
Antibiotic combinations for serious infections caused by carbapenem-resistant Acinetobacter baumannii in a mouse pneumonia model.
Successful therapy of carbapenem-resistant Acinetobacter baumannii strains has been reported with colistin, but recently we argued against its use as monotherapy because of the poor results obtained in a mouse pneumonia model. Our aim was to identify antibiotic combinations that were valid therapeutic alternatives in the same model. ⋯ Our data indicate that imipenem can still be the best alternative for carbapenem-resistant A. baumannii infections with moderate levels of imipenem resistance, preferably combined with aminoglycosides. For strains highly resistant to imipenem, a combination of rifampicin with imipenem, tobramycin or colistin may be useful, if resistance to rifampicin is only moderate.