International journal of antimicrobial agents
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Int. J. Antimicrob. Agents · Feb 2004
Randomized Controlled Trial Comparative Study Clinical TrialFive-day moxifloxacin therapy compared with 7-day co-amoxiclav therapy for the treatment of acute exacerbation of chronic bronchitis.
In this randomized, non-blinded study, the efficacy and safety of a 5-day course of moxifloxacin (one 400 mg tablet daily) was compared with that of co-amoxiclav (one 625 mg tablet every 8h) for 7 days, for the treatment of acute exacerbations of chronic bronchitis (AECB). A total of 162 patients with clear signs of an acute exacerbation of chronic bronchitis were enrolled. Of these, 153 could be studied. ⋯ The eradication rate at 14 days in the valid patients was similar for both groups, 90.9% (20 of 22) for the moxifloxacin group and 90.0% (18 of 20) for the co-amoxiclav group. Both drugs were well tolerated with no differences in the drug-related adverse effects or the patients withdrawing because of an adverse event. These results and the good spectrum of antibacterial activity make moxifloxacin a promising and also safe alternative for the empirical treatment of AECB.
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Int. J. Antimicrob. Agents · Dec 2003
Audit of an antibiotic policy and microbiological investigations for treating bacteraemia in a large teaching hospital.
An audit of different approaches to guide empirical therapy in 78 cases of bacteraemia revealed poor utilisation of the antibiotic policy with resulting inadequate (P=0.005) or excessive (P<0.00001) antibiotic treatment and a trend to increased mortality. Eighty-seven percent of blood cultures were positive on Gram-stain within 24 h but streamlined therapy was still judged excessive in 27%. The results show poor utilisation of an up-to-date antibiotic policy but confirm its potential benefits and the ability of traditional culture methods to guide antibiotic therapy in a useful time-scale.
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Int. J. Antimicrob. Agents · Oct 2003
Review Comparative StudyShort term therapy for uncomplicated urinary tract infection today. Clinical outcome upholds the theories.
The clinical and bacteriological activity of fosfomycin trometamol (FT) has been compared with several other antibiotics in the treatment of uncomplicated urinary tract infections. A single dose of FT had activity comparable with a 5-day course of trimethoprim in a trial where the causative organism and its sensitivity were unknown. In another trial FT showed better long term eradication compared with a 5-day course of cephalexin and other studies suggested a single dose of FT was comparable with a 7-day course of nitrofurantoin or norfloxacin. There were few important side effects with fosfomycin therapy and it was considered a safe and effective first line treatment in uncomplicated urinary tract infection.
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Int. J. Antimicrob. Agents · Aug 2003
Molecular epidemiology of Enterobacteriaceae producing extended-spectrum beta-lactamase in a French university-affiliated hospital.
We conducted a retrospective study to investigate the epidemiology of Enterobacteriaceae producing extended-spectrum beta-lactamase (ESBLE) in our hospital. We determined the occurrence of extended-spectrum beta-lactamase (ESBL) in Enterobacteriaceae over a 2-year period. We also characterised ESBLs by isoelectric focusing (IEF) and investigated the epidemiological relatedness of EBLSE by pulsed field gel electrophoresis (PFGE). ⋯ Indeed, 59.5% of ESBLE were E. aerogenes and 21.9% of the other ESBLE resulted from a plasmid transfer originating from E. aerogenes. IEF and PFGE analysis demonstrated that the dissemination of ESBL from E. aerogenes in our hospital was due to a single clone that always harbours TEM-24. This emphasises the importance of standard contact isolation precautions and the early detection of ESBLE-colonised patients in high risk departments like intensive care units.
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Int. J. Antimicrob. Agents · Jun 2003
Target site bacterial killing of cefpirome and fosfomycin in critically ill patients.
We employed an in-vivo pharmacokinetic/in-vitro pharmacodynamic method to simulate bacterial killing in plasma and the interstitium of skeletal muscle tissue after intravenous administration of 2 g of cefpirome and 8 g of fosfomycin alone and in combination to patients with sepsis. Interstitial antimicrobial concentrations were determined by use of in-vivo microdialysis. CFU/ml of Staphylococcus aureus (ATCC 29213) and Pseudomonas aeruginosa (clinical isolate) decreased by approximately 2log(10) for plasma and muscle tissue 6 h after cefpirome and fosfomycin administration compared with the baseline, respectively. ⋯ The in-vitro simulation of in-vivo plasma and tissue pharmacokinetics of cefpirome and fosfomycin has shown that both antimicrobial agents kill S. aureus and P. aeruginosa strains effectively after single dose administration. This effect was most pronounced by the combined use of these antimicrobial agents. Therefore, this data corroborates antimicrobial strategies of simultaneous administration of cefpirome and fosfomycin in patients with severe soft tissue infection.