Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
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Vancomycin is often combined with a second antibiotic, most often rifampin or gentamicin, for the treatment of serious methicillin-resistant Staphylococcus aureus infections. Published data from experiments evaluating these and other vancomycin-based combinations, both in vitro and in animal models of infection, often yield inconsistent results, however. More importantly, no data are available from randomized clinical trials to support their use, and some regimens are known to have potential toxicities. Clinicians should carefully reconsider the use of vancomycin-based combination therapies for the treatment of infection due to methicillin-resistant S. aureus.
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The early detection of circulatory failure in patients with sepsis is important for successful treatment. Heparin-binding protein (HBP), released from activated neutrophils, is a potent inducer of vascular leakage. In this study, we investigated whether plasma levels of HBP could be used as an early diagnostic marker for severe sepsis with hypotension. ⋯ In febrile patients, high plasma levels of HBP help to identify patients with an imminent risk of developing sepsis with circulatory failure.
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Case Reports
Pharmacokinetics of moxifloxacin in cerebrospinal fluid and plasma in patients with tuberculous meningitis.
Moxifloxacin cerebrospinal fluid (CSF) penetration was evaluated by obtaining full plasma and CSF time concentration curves for 4 patients with tuberculous meningitis. The geometric mean ratio of the areas under the curve for CSF to plasma were 0.82 (range, 0.70-0.94) at 400 mg once per day and 0.71 (0.58-0.84) at 800 mg once per day.