MedWorm: Ceftriaxone

CEFTRIAXONE SODIUMinjection, Powder, For Solution [Cardinal Health]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Thu, 02 Feb 2012 05:00:00 +0100

Updated Date: Feb 2, 2012 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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Randomized Trial of Oral Versus Sequential IV/Oral Antibiotic for Acute Pyelonephritis in Children

PEDIATRICS — Wed, 01 Feb 2012 05:00:00 +0100

CONCLUSIONS: Although this trial does not statistically demonstrate the noninferiority of oral treatment compared with the sequential treatment, our study confirmed the results of previously published reports and therefore supports the use of an oral antibiotic treatment of primary episodes of acute pyelonephritis in infants and young children. (Source: PEDIATRICS)

Electromagnetic irradiation of Enterococcus hirae at low‐intensity 51.8 and 53.0 GHz frequencies: changes in bacterial cell membrane properties and enhanced antibiotics effects

FEMS Microbiology Letters — Tue, 31 Jan 2012 05:00:00 +0100

AbstractElectromagnetic irradiation (EMI) of 51.8 and 53.0 GHz frequencies with low‐intensity (the flux capacity of 0.06 mW cm−2) and with exposure during 1 h markedly decreased the energy‐dependent H+ and K+ transport across the membranes of Enterococcus hirae ATCC9790. After EMI, a significant decrease of the overall and N,N’‐dicyclohexylcarbodiimide (DCCD) sensitive ATPase activity of the membrane vesicles occurred as well. They were considerably lowered with 53.0 GHz frequency. EMI in combination with different antibiotics, such as ceftriaxone and kanamycin in their minimal inhibitory concentrations (100 μM and 200 μM, correspondingly), had enhanced effects on the bacterial cell growth and the changes in their membrane transport properties. Especially, total H+ efflux was m...

Cotrimoxazole Prophylaxis Specifically Selects for Cotrimoxazole Resistance in Streptococcus mutans and Streptococcus sobrinus with Varied Polymorphisms in the Target Genes folA and folP

International Journal of Photoenergy — Tue, 24 Jan 2012 18:18:57 +0100

The selection of antibiotic resistance by cotrimoxazole prophylaxis was evaluated, and we characterized the mechanism of cotrimoxazole resistance in Streptococcus mutans and Streptococcus sobrinus. In vitro susceptibility to six antibiotics was evaluated on 64 mutans streptococci group (MSG) isolates from a cotrimoxazole prophylaxis group and compared to 84 MSG isolates from a nonprophylaxis group. The folA and folP genes were sequenced and compared with reference sequences at NCBI. Only resistance to cotrimoxazole was significantly higher in the prophylaxis group (54.7% versus 15.5%, OR=6.59, 95% CI: 2.89–15.3, P<0.05). Resistance to amoxicillin, ceftriaxone, chloramphenicol, erythromycin, and tetracycline was 1.4%, 25.5%, 6.2%, 6.5%, and 29.6% of ...

CEFTRIAXONE (Ceftriaxone Sodium) Injection, Solution [Baxter Healthcare Corporation]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Thu, 19 Jan 2012 05:00:00 +0100

Updated Date: Jan 19, 2012 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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Ceftriaxone: Autoimmune haemolytic anaemia and renal failure in a child: case report

Reactions — Tue, 17 Jan 2012 19:08:18 +0100

(Source: Reactions)

In vitro antimicrobial resistance of urinary E. coli among U.S. outpatients from 2000 to 2010.

Antimicrobial Agents and Chemotherapy — Tue, 17 Jan 2012 05:00:00 +0100

This study examines in-vitro antimicrobial resistance data from E. coli urine isolates from U.S. outpatients between 2000 and 2010 using The Surveillance Network (TSN). Antimicrobial susceptibility results (n=12,253,679) showed the greatest increases in E. coli resistance from 2000 to 2010 for ciprofloxacin (3% to 17.1%) and TMP/SMX (17.9% to 24.2%), whereas nitrofurantoin (0.8% to 1.6%) and ceftriaxone (0.2% to 2.3%) showed minimal change. From 2000 to 2010, outpatient urinary E. coli antimicrobial resistance to ciprofloxacin and TMP/SMX increased substantially. PMID: 22252813 [PubMed - as supplied by publisher] (Source: Antimicrobial Agents and Chemotherapy)

The Role of Rifampin against Propionibacterium acnes Biofilm in vitro and in an Experimental Foreign-Body Infection Model.

Antimicrobial Agents and Chemotherapy — Tue, 17 Jan 2012 05:00:00 +0100

Authors: Furustrand Tafin U, Corvec S, Betrisey B, Zimmerli W, Trampuz A Abstract Propionibacterium acnes is an important cause of orthopedic implant-associated infections, for which the optimal treatment has not yet been determined. We investigated the activity of rifampin, alone and in combination, against planktonic and biofilm P. acnes in vitro and in a foreign-body infection model. The MIC and the minimal bactericidal concentration (MBC) were 0.007 and 4 μg/ml for rifampin, 1 and 4 μg/ml for daptomycin, 1 and 8 μg/ml for vancomycin, 1 and 2 μg/ml for levofloxacin, 0.03 and 16 μg/ml for penicillin G, 0.125 and 512 μg/ml for clindamycin, and 0.25 and 32 μg/ml for ceftriaxone, respectively. The P. acnes minimal biofilm eradication concentration (MBEC) was 16 μg/ml for rif...

Genotypes and serotype distribution of macrolide resistant invasive and non- invasive Streptococcus pneumoniae isolates from Lebanon

Annals of Clinical Microbiology and Antimicrobials — Mon, 16 Jan 2012 05:00:00 +0100

Conclusion: Macrolide resistance in S. pneumoniae in Lebanon is mainly through target site modification but is also mediated through efflux pumps, with serotype 19F having dual resistance and being the most prevalent and invasive. (Source: Annals of Clinical Microbiology and Antimicrobials)

Ceftriaxone-induced acute reversible encephalopathy in a patient with enteric fever

Indian Journal of Pharmacology — Sat, 14 Jan 2012 05:00:00 +0100

We describe a case of acute transient encephalopathy in a patient treated with ceftriaxone for enteric fever infection. Early detection of this complication is relevant given that stopping the drug usually reverts the neurological syndrome. (Source: Indian Journal of Pharmacology)

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Ceftriaxone/dipyrone: Agranulocytosis and sepsis: case report

Reactions — Fri, 13 Jan 2012 23:22:43 +0100

(Source: Reactions)

Ceftriaxone: Autoimmune hepatitis and hepatic failure in an elderly patient: case report

Reactions — Fri, 13 Jan 2012 23:22:43 +0100

(Source: Reactions)

Emergence of fluoroquinolone resistance in Shigella flexneri serotype 1c isolates from China

Clinical Microbiology and Infection — Fri, 13 Jan 2012 05:00:00 +0100

We reported the first identification of Shigella flexneri serotype 1c in China and also the emergence of resistance to ciprofloxacin and third‐generation cephalosporins in serotype 1c the first time. Seven isolates circulating in China were divided into three new MLST sequence types and seven PFGE banding patterns, demonstrating the high genetic diversity. The seven isolates showed reduced susceptibility to ciprofloxacin, among which one had ciprofloxacin‐resistance and an additional one developed resistance to ciprofloxacin, norfloxacin, cefotaxime and ceftriaxone. (Source: Clinical Microbiology and Infection)

A Comparison of the Prevalence and Antimicrobial Resistance of Escherichia coli from Different Retail Meats in the United States: 2002-2008.

Applied and Environmental Microbiology — Fri, 13 Jan 2012 05:00:00 +0100

Authors: Zhao S, Blickenstaff K, Bodeis-Jones S, Gaines SA, Tong E, McDermott PF Abstract Escherichia coli were recovered from the National Antimicrobial Resistance Monitoring System retail meat program and examined for antimicrobial susceptibility. Retail meat samples (N= 11,921) from four U.S. states collected during 2002-2008 were analyzed, consisting of 2,988 chicken breast, 2,942 ground turkey, 2,991 ground beef and 3,000 pork chops. A total of 8,286 E. coli were recovered. Most chicken (83.5%) and turkey (82.0%) were contaminated with the organism, followed by beef (68.9%) and pork (44.0%). Resistance to tetracycline was most common (50.3%), followed by streptomycin (34.6%), sulfamethoxazole/sulfisoxazole (31.6%), ampicillin (22.5%), gentamicin (18.6%), kanamycin (8.4%), amox...

Is adjunctive corticosteroid beneficial in pneumococcal meningitis in a region with high rates of resistance to penicillin and ceftriaxone?

Journal of Neurology — Fri, 06 Jan 2012 06:44:39 +0100

Abstract The role of adjunctive corticosteroids remains controversial in meningitis by penicillin-resistant pneumococci. We determined the effect of adjunctive corticosteroids in adults with pneumococcal meningitis in a region with a high rate of penicillin resistance. A multicenter, retrospective cohort study was conducted between 1998 and 2008 in Korea. The mortality and neurological sequelae were evaluated. Among 93 patients with pneumococcal meningitis, adequate adjunctive corticosteroids were given in 45.2%. The penicillin resistance rate was 60.0%, and 42.1% were nonsusceptible to ceftriaxone. The 30-day mortality rates in the group receiving adequate corticosteroid therapy, the group in which corticosteroid was not given, and that inadequately given were 24.3, 31.6,...

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Successful treatment of Nocardia pneumonia with cytomegalovirus retinitis coinfection in a renal transplant recipient

International Urology and Nephrology — Wed, 04 Jan 2012 06:59:18 +0100

We report a case of pulmonary nocardiosis associated with cytomegalovirus retinitis in a renal transplant recipient, followed by chronic allograft dysfunction. Our patient was a 50-year-old male renal allograft recipient, with diabetes mellitus and hypertension, who was diagnosed with pneumonia and cytomegalovirus retinitis. High-resolution computed tomography scan of the thorax and bronchoscopy revealed nocardial pneumonia. The patient responded well to ceftriaxone and was later switched to oral minocycline. To our knowledge, this is the first report of a successful treatment of co-infection with Nocardia pneumonia and cytomegalovirus retinitis in a renal transplant patient, with early diagnosis and prompt treatment. Content Type Journal ArticleCategory Nephrology – Case Repor...

Capacitive Coupling Reduces Instrumentation-related Infection in Rabbit Spines: A Pilot Study.

Clinical Orthopaedics and Related Research — Wed, 04 Jan 2012 05:00:00 +0100

CONCLUSIONS: Capacitive coupling in conjunction with antibiotics reduced the instrumentation-related infection rate compared with antibiotics alone. CLINICAL RELEVANCE: Capacitive coupling noninvasively delivers an alternating current that may detach biofilm from instrumentation. Treatment of infection may be successful without removal of instrumentation, allowing for improved stability and overall decreased morbidity. PMID: 22215478 [PubMed - as supplied by publisher] (Source: Clinical Orthopaedics and Related Research)

Cefoxitin as an alternative to carbapenems in a murine model of urinary tract infection due to Escherichia coli harboring CTX-M-15 type extended-spectrum beta-lactamase.

Antimicrobial Agents and Chemotherapy — Tue, 03 Jan 2012 05:00:00 +0100

In conclusion, FOX appears as an effective therapeutic alternative to carbapenems for the treatment of UTI due to CTX-M-producing E. coli. PMID: 22214774 [PubMed - as supplied by publisher] (Source: Antimicrobial Agents and Chemotherapy)

Experience developing national evidence based clinical guidelines for childhood pneumonia in a low-income setting - making the GRADE?

BMC Pediatrics - Latest articles — Sun, 01 Jan 2012 05:00:00 +0100

Conclusions: Although this exercise may have fallen short of the rigorous requirements recommended by the developers of GRADE, it was arguably an improvement on previous attempts at guideline development in low-income countries and offers valuable lessons for future similar exercises where resources and locally-generated evidence are scarce. (Source: BMC Pediatrics - Latest articles)

Long-term trends in the epidemiology and resistance of childhood bacterial enteropathogens in Crete

European Journal of Clinical Microbiology and Infectious Diseases — Fri, 30 Dec 2011 06:51:16 +0100

In this study, we investigated the long-term trends in the epidemiology and susceptibility of bacterial enteropathogens among children in a well-defined area of adequate health standards. The study included all children younger than 14 years of age treated for enteritis at Heraklion University General Hospital on the island of Crete during the 18-year period from January 1993 to December 2010. Stool specimens were tested for Salmonella, Shigella, Campylobacter, enteropathogenic Escherichia coli (EPEC), Yersinia, and Aeromonas species. Of the 33,032 stool samples from patients of any age, 2,912 (8.82%) were positive for bacterial enteropathogens. The 1,597 isolates from children were identified as S. enterica (42.3%), Campylobacter spp. (33.6%), EPEC (17.4%), Y. enterocolitica (5.82%), ...

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Emergence of Ceftriaxone Resistant Shigella

Indian Journal of Pediatrics — Wed, 28 Dec 2011 16:46:44 +0100

Abstract Shigellosis is endemic in many resource-poor countries due to feco-oral transmission, resulting in considerable morbidity and mortality. There is rapid emergence of multi-drug resistant (MDR) Shigella spp. resulting in poor reliability of first line antibiotics like quinolones, co-trimoxazole and ampicillin. Ceftriaxone has been used as a reserved antibiotic for treatment of MDR Shigella spp. The authors report a case of ceftriaxone resistant Shigella flexneri successfully managed with meropenem. As occurrence of ceftriaxone resistant Shigella is still rare, the objective of reporting this case is to highlight the possible failure of ceftriaxone in treating shigellosis which if not detected timely can result in mortality. Content Type Journal ArticleCategory Cl...

CEFTRIAXONE (Ceftriaxone Sodium) Injection, Powder, For Solution [Sagent Pharmaceuticals]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Tue, 20 Dec 2011 05:00:00 +0100

Updated Date: Dec 20, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Isolated trochlear palsy secondary to Lyme neuroborreliosis

International Ophthalmology — Mon, 19 Dec 2011 16:54:34 +0100

The objective of the study is to report the first case of isolated trochlear palsy secondary to Lyme neuroborreliosis in an adult. A 22-year-old male presented with history of flu-like illness and headache, accompanied by vertical binocular diplopia, worse on downgaze and better in upgaze and right head tilt. Physical examination revealed trochlear palsy on the left side with a compensatory head tilt to the opposite side. A subsequent workup for trochlear palsy was conducted, including hematological and cerebral spinal fluid serum studies, and magnetic resonance imaging of the brain. Immunoglobulin (Ig)M and IgG antibodies against Borrelia burgdorferi were positive in serum and cerebral spinal fluid (CSF). Symptoms of double vision completely resolved after 3 weeks of antibiotic ...

Anal Extrusion of a Ventriculoperitoneal Shunt Catheter

Journal of Pakistan Medical Students — Mon, 19 Dec 2011 05:00:00 +0100

We report a case of a two-year-old female child who presented to the emergency department when her mother noticed the shunt catheter protruding from her anus four months after shunt placement. The shunt tube was removed and the patient underwent repeat ventriculoperitoneal shunting on the left side two weeks after shunt removal. Removal of the catheter by a less invasive method is advisable in the absence of infection. Exteriorization of the proximal end is recommended as it can be useful to rule out ventriculitis and meningitis and also to assess the dependency on shunt followed by placement of new shunt after control of the infection. Key words: Bowel perforation; Ventriculoperitoneal shunt; Anal extrusion INTRODUCTION Bowel perforation and spontaneous extrusion of the l...

Glutamate Transporter GLT-1 Upregulation Attenuates Visceral Nociception and Hyperalgesia via Spinal Mechanisms Not Related to Anti-Inflammatory or Probiotic Effects

Clinical and Developmental Immunology — Mon, 12 Dec 2011 23:53:11 +0100

Visceral pain is the most common reason for physician visits in US. Glutamate is the major excitatory neurotransmitter and mediates visceral nociceptive neuro-transmission and hypersensitivity. Removal of extracellular glutamate is predominantly mediated by glial glutamate transporter-1 (GLT-1). The pharmacological approach to up-regulate GLT-1 by 1 week administration of ceftriaxone (CTX) has been successful to mitigate visceral nociception. The present study shows that intrathecal delivery of selective GLT-1 antagonist dihydrokainate reversed CTX-blunted visceral nociceptive response, suggesting a spinal site of action. The role of GLT-1 up-regulation in animal models of colitis was studied. CTX treatment reversed TNBS-induced visceral hypersensitivity. In addition, CTX treatment initiat...

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Acute pyelonephritis in women (2011 review)

Clinical Cases and Images — Mon, 12 Dec 2011 13:26:00 +0100

This is a 2011 review from the official journal of the AAFP, American Family Physician:Acute pyelonephritis is a bacterial infection of the renal pelvis and kidney most often seen in young women.Symptoms of acute pyelonephritisMost patients have fever, although it may be absent early in the illness. Flank pain is nearly universal.Tests for acute pyelonephritisA positive urinalysis confirms the diagnosis.Urine culture should be obtained in all patients to guide antibiotic therapy if the patient does not respond to initial empiric antibiotic regimens.Escherichia coli is the most common pathogen in acute pyelonephritis. In the past decade, there has been an increasing rate of E. coli resistance to extended-spectrum beta-lactam antibiotics.Imaging, usually with contrast-enhanced CT is not nece...

Comparison of European Committee on Antimicrobial Susceptibility Testing (EUCAST) and CLSI screening parameters for the detection of extended-spectrum {beta}-lactamase production in clinical Enterobacteriaceae isolates

Journal of Antimicrobial Chemotherapy — Mon, 12 Dec 2011 05:00:00 +0100

Conclusions EUCAST non-susceptible breakpoints for ceftazidime and cefpodoxime detect more ESBL-producing Enterobacteriaceae isolates compared with corresponding CLSI ESBL screening breakpoints. Implementation of the cefepime DAM can facilitate ESBL screening, especially in strains producing an AmpC β-lactamase since the test shows high sensitivity and specificity. (Source: Journal of Antimicrobial Chemotherapy)

Comparison of antimicrobial resistance patterns of Salmonella spp. and Escherichia coli recovered from pet dogs from volunteer households in Ontario (2005-06)

Journal of Antimicrobial Chemotherapy — Mon, 12 Dec 2011 05:00:00 +0100

Conclusions Pet dogs are a potential household source of antimicrobial-resistant Salmonella spp. and E. coli. However, extrapolating the epidemiology of antimicrobial resistance in pathogens, like Salmonella, from E. coli should be done with caution. (Source: Journal of Antimicrobial Chemotherapy)

High-level cefixime- and ceftriaxone-resistant N. gonorrhoeae in Europe (France): novel penA mosaic allele in a successful international clone causes treatment failure.

Antimicrobial Agents and Chemotherapy — Mon, 12 Dec 2011 05:00:00 +0100

Authors: Unemo M, Golparian D, Nicholas R, Ohnishi M, Gallay A, Sednaoui P Abstract Recently, the first Neisseria gonorrhoeae strain (H041) highly resistant to the extended-spectrum cephalosporins (ESC) ceftriaxone and cefixime, which are the last remaining options for first-line gonorrhoea treatment, was isolated in Japan. Here, we confirm and characterize a second strain (F89) with high-level cefixime and ceftriaxone resistance, which was isolated in France and most likely caused a treatment failure with cefixime. F89 was examined using six species-confirmatory tests, antibiograms (33 antimicrobials), porB sequencing, N. gonorrhoeae multiantigen sequence typing (NG-MAST), multilocus sequence typing (MLST), and sequencing of known gonococcal resistance determinants (penA, mtrR, pe...

The efficacy and tolerability of antibiotic combinations in neurobrucellosis: results of the istanbul study.

Antimicrobial Agents and Chemotherapy — Mon, 12 Dec 2011 05:00:00 +0100

THE EFFICACY AND TOLERABILITY OF ANTIBIOTIC COMBINATIONS IN NEUROBRUCELLOSIS: RESULTS OF THE ISTANBUL STUDY. Antimicrob Agents Chemother. 2011 Dec 12; Authors: Erdem H, Ulu A, Kilic S, Karahocagil M, Sheeta G, Eren-Tulek N, Yetkin F, Celen MK, Ceran N, Gul HC, Mert G, Tekin-Koruk S, Dizbay M, Inal AS, Nayman-Alpat S, Bosilkovski M, Inan D, Saltoglu N, Abdel-Baky L, Adeva-Bartolome MT, Ceylan B, Sacar S, Turhan V, Yilmaz E, Elaldi N, Kocak-Tufan Z, Ugurlu K, Dokuzoguz B, Yilmaz H, Gundes S, Guner R, Ozgunes N, Ulcay A, Unal S, Dayan S, Gorenek L, Karakas A, Tasova Y, Usluer G, Bayindir Y, Kurtaran B, Sipahi OR, Leblebicioglu H Abstract No datum exists in the literature whether Brucellar meningitis or meningoencephalitis can be treated with oral antibiotics or should an intra...

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Postoperative disc space infection after discectomy: A report on thirty-five patients

International Orthopaedics — Thu, 08 Dec 2011 18:24:45 +0100

Conclusion Re-exploration is recommended if no response is achieved after four day’s conservative treatment for or if the patient’s condition is critical. Content Type Journal ArticleCategory Original PaperPages 1-6DOI 10.1007/s00264-011-1430-4Authors Thamer A. Hamdan, Basrah Medical College, P.O. Box 763, Basrah, Iraq Journal International OrthopaedicsOnline ISSN 1432-5195Print ISSN 0341-2695 (Source: International Orthopaedics)

Ceftriaxone: Cholestatic hepatitis: case report

Reactions — Thu, 01 Dec 2011 07:29:01 +0100

(Source: Reactions)

Emergency Department Laboratory Evaluations of Fever Without Source in Children Aged 3 to 36 Months

PEDIATRICS — Thu, 01 Dec 2011 05:00:00 +0100

CONCLUSIONS: Most US emergency department visits for FWS among children aged 3 to 36 months, physicians do not order diagnostic tests. Being female, having a higher fever, and higher median income of the patient's zip code were associated with ordering CBCs and urinalysis. (Source: PEDIATRICS)

Isolated abducens nerve palsy secondary to Lemierre syndrome

Journal of AAPOS — Thu, 01 Dec 2011 05:00:00 +0100

Lemierre syndrome is characterized by pharyngotonsillitis that is typically secondary to Fusobacterium necrophorum infection and causes adjacent septic thrombophlebitis and thrombosis with subsequent metastatic abscesses. A 3-year-old boy presented with fever, tonsillar enlargement, and bilateral otomastoiditis with purulent discharge. Physical examination revealed abducens nerve palsy on the left side, with a compensatory left head turn. Otomastoid discharge culture was positive for anaerobic F. necrophorum. Magnetic resonance venography of the head and neck revealed thromboses in left internal jugular vein, left cavernous sinus, left superior ophthalmic vein, and left sigmoid sinus. The patient was treated with anticoagulation and a 10-week course of intravenous antibiotics, including ce...

CDC update on gonorrhea: Expand treatment to limit resistance.

The Journal of Family Practice — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Campos-Outcalt D Abstract In all cases, add azithromycin to ceftriaxone or an acceptable alternative agent, and screen asymptomatic individuals at high risk of infection. PMID: 22163356 [PubMed - in process] (Source: The Journal of Family Practice)

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Antimicrobial susceptibility profiles associated with bacterial meningitis among children: A referral hospital-based study in Iran.

Acta Microbiologica et Immunologica Hungarica — Thu, 01 Dec 2011 05:00:00 +0100

In conclusion, despite the advances in antibiotic therapy and vaccine development, bacterial meningitis still is a health problem. S. pneumoniae, H. influenzae, and N. meningitidis are the main sources of bacterial meningitis, but other organisms such as E. coli should also be suspected, when a case is admitted to a referral pediatric hospital. PMID: 22207285 [PubMed - in process] (Source: Acta Microbiologica et Immunologica Hungarica)

Adverse events induced by ceftriaxone: a 10‐year review of reported cases to Iranian Pharmacovigilance Centre

Journal of Clinical Pharmacy and Therapeutics — Mon, 28 Nov 2011 05:00:00 +0100

Conclusion: Severe and life‐threatening adverse reactions induced by ceftriaxone are of great concern. Rapid intravenous injection, unlabelled use and previous patient history of allergic reactions to cephalosporins or penicillins are risk factors that should be guarded against. (Source: Journal of Clinical Pharmacy and Therapeutics)

Evaluation of a Diagnostic Flow‐Chart for Detection and Confirmation of Extended Spectrum β‐lactamases (ESBL) in Enterobacteriaceae

Clinical Microbiology and Infection — Sat, 26 Nov 2011 05:00:00 +0100

This study aimed at developing a modular, diagnostic algorithm for ESBL detection in Enterobacteriaceae. Clinical Enterobacteriaceae strains (n=2518) were screened for ESBL production using CLSI breakpoints for third generation cephalosporins and by synergy image detection (clavulanic acid / extended‐spectrum cephalosporins). ESBL screening positive isolates (n=242, 108 by critical CLSI diameters alone, 5 by double disk synergy test (DDST) alone, and 129 by both critical diameters and DDST) and 138 ESBL screening negative isolates (control group) were investigated by molecular methods considered the gold standard (multiplex CTX‐M type PCR, TEM and SHV type sequence characterization). 124/242 ESBL screening positive Enterobacteriaceae isolates were confirmed ESBL positive by the gold st...

Evaluation of a diagnostic flow chart for detection and confirmation of extended spectrum β‐lactamases (ESBL) in Enterobacteriaceae

Clinical Microbiology and Infection — Sat, 26 Nov 2011 05:00:00 +0100

This study aimed to develop a modular, diagnostic algorithm for extended spectrum β‐lactamase (ESBL) detection in Enterobacteriaceae. Clinical Enterobacteriaceae strains (n = 2518) were screened for ESBL production using Clinical and Laboratory Standards Institute (CLSI) breakpoints for third‐generation cephalosporins and by synergy image detection (clavulanic acid/extended‐spectrum cephalosporins). Isolates screening positive for ESBL (n = 242, 108 by critical CLSI diameters alone, five by double disk synergy test (DDST) alone, and 129 by both critical diameters and DDST) and 138 ESBL screening negative isolates (control group) were investigated by molecular methods considered to be the reference standard (multiplex CTX‐M type PCR, TEM and SHV type sequence characterizati...

In vitro Activity Effects of Twelve Antibiotics Alone and in Association against Twenty-Seven Enterococcus faecalis Strains Isolated from Italian Patients with Infective Endocarditis: High in vitro Synergistic Effect of the Association Ceftriaxone-Fosfomycin

Chemotherapy — Fri, 25 Nov 2011 23:00:00 +0100

Chemotherapy 2011;57:426–433 (DOI:10.1159/000330458) (Source: Chemotherapy)

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Enteric fever in returning travellers: Role of outpatient parenteral antibiotic therapy

Journal of Infection — Thu, 24 Nov 2011 05:00:00 +0100

In a recent review of imported enteric fever in Leicester, UK, a shift in therapy from ciprofloxacin to ceftriaxone and azithromycin was observed between 1999 and 2009, reflecting reduced ciprofloxacin sensitivity (MIC 0.125–1 mg/L) amongst Salmonella enterica isolates across Asia. (Source: Journal of Infection)

High Level Resistance to Gentamicin: Genetic Transfer Between Enterococcus Faecalis Isolated From Food of Animal Origin and Human Microbiota

Letters in Applied Microbiology — Wed, 23 Nov 2011 14:26:40 +0100

Conclusion: The in vivo gene transfer of HLRG from E. faecalis strains, isolated from food of animal origin, to human microbiota has been demonstrated in a mouse model.Significance and Impact of the Study: The complexity found on the therapeutic responses of invasive infectious diseases caused by E. faecalis, facilitates the assessment of food of animal origin as a resistant‐pathogen reservoir. In addition, this study may contribute to the understanding of antimicrobials resistance gene transfer between E. faecalis strains from food and human GI tract. (Source: Letters in Applied Microbiology)

Clinical outcome of pneumococcal meningitis during the emergence of pencillin-resistant Streptococcus pneumoniae: an observational study

BMC Infectious Diseases — Mon, 21 Nov 2011 05:00:00 +0100

Conclusions: Findings support the use of third generation cephalosporin antibiotics for treatment of suspected pneumococcal meningitis even at low prevalence of pneumococcal resistance to penicillins. (Source: BMC Infectious Diseases)

High‐level resistance to gentamicin: genetic transfer between Enterococcus faecalis isolated from food of animal origin and human microbiota

Letters in Applied Microbiology — Sun, 20 Nov 2011 05:00:00 +0100

Conclusions: The in vivo gene transfer of HLRG from Ent. faecalis strains, isolated from the food of animal origin, to human microbiota has been demonstrated in a mouse model.Significance and Impact of the Study: The complexity found on the therapeutic responses of invasive infectious diseases caused by Ent. faecalis facilitates the assessment of food of animal origin as a resistant pathogen reservoir. In addition, this study may contribute to the understanding of antimicrobials’ resistance gene transfer between Ent. faecalis strains from food and human GI tract. (Source: Letters in Applied Microbiology)

Clinical management of ESBL-producing Enterobacteriaceae: the insidious role of fluoroquinolones

European Journal of Clinical Microbiology and Infectious Diseases — Fri, 18 Nov 2011 06:55:57 +0100

Abstract During a review of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae in our Hospital, a huge number of inadequate antimicrobial therapies emerged. The aim of this study is to assess the factors related to such inadequacy. This retrospective analysis was performed on isolates reported by the microbiology laboratory. Medical records were analyzed to assess adequate treatment; inadequacy was evaluated as overall therapy, antibiotic choice, dosage and length of treatment. Linear regression and multivariate analysis were performed to assess any association. One hundred and fifty isolates were analyzed. They were more commonly isolated from urinary samples and from patients admitted to the Internal Medicine Department; E. coli was the most commonly isola...

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Pneumocephalus and pneumococcal meningitis after thoracic surgery [CASE STUDIES]

Asian Cardiovascular and Thoracic Annals — Fri, 18 Nov 2011 05:00:00 +0100

A 62-year-old man with adenocarcinoma underwent complete resection with a right upper lobectomy and en-bloc resection of the chest wall, with metallic clips applied to the vertebral nerve roots. A sudden deterioration in neurological status occurred due to pneumocephalus and ascending bacterial meningitis resulting from a subarachnoid-pleural fistula. The neurological status normalized after thoracoplasty and ceftriaxone treatment. (Source: Asian Cardiovascular and Thoracic Annals)

CEFTRIAXONE AND DEXTROSE (Ceftriaxone) Injection, Solution [B. Braun Medical Inc.]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Fri, 18 Nov 2011 05:00:00 +0100

Updated Date: Nov 18, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Amoxicillin/ceftriaxone/lamotrigine: Drug hypersensitivity reactions in pediatric patients: 3 case reports

Reactions — Wed, 16 Nov 2011 21:59:42 +0100

(Source: Reactions)

Ceftriaxone: Immune haemolytic anaemia in an infant: case report

Reactions — Wed, 16 Nov 2011 21:59:42 +0100

(Source: Reactions)

Diarrhea associated with Shigella in children and susceptibility of the bacterium to antimicrobials: a study in Teresina, Piauí, Northeast of Brazil.

Jornal de Pediatria — Wed, 16 Nov 2011 05:00:00 +0100

CONCLUSIONS: S. flexneri is common in Teresina. The resistance to ampicillin and sulphametoxazole-trimethoprim gives cause for concern, as these drugs are widely used in practice and sulphametoxazole-trimethoprim is also recommended for treating children suspected of having shigellosis. PMID: 22089139 [PubMed - as supplied by publisher] (Source: Jornal de Pediatria)

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Intermittent Hypobaric Hypoxia Preconditioning Induced Brain Ischemic Tolerance by Up-Regulating Glial Glutamate Transporter-1 in Rats.

Neurochemical Research — Sat, 12 Nov 2011 05:00:00 +0100

Authors: Gong SJ, Chen LY, Zhang M, Gong JX, Ma YX, Zhang JM, Wang YJ, Hu YY, Sun XC, Li WB, Zhang Y Abstract Several studies showed that the up-regulation of glial glutamate transporter-1 (GLT-1) participates in the acquisition of brain ischemic tolerance induced by cerebral ischemic preconditioning or ceftriaxone pretreatment in rats. To explore whether GLT-1 plays a role in the acquisition of brain ischemic tolerance induced by intermittent hypobaric hypoxia (IH) preconditioning (mimicking 5,000 m high-altitude, 6 h per day, once daily for 28 days), immunohistochemistry and western blot were used to observe the changes in the expression of GLT-1 protein in hippocampal CA1 subfield during the induction of brain ischemic tolerance by IH preconditioning, and the effect of dihydr...

Antibiotic Resistance of Bacterial Strains Isolated from Patients with Community-Acquired Urinary Tract Infections: an Exploratory Study in Palestine.

Current Clinical Pharmacology — Fri, 11 Nov 2011 05:00:00 +0100

Conclusion: E. coli was the most frequent bacterium in the studied sample and showed high resistance to first-line antibiotics. Our results highlight the need for developing local guidelines where elevated resistance to antibiotics should influence prescribing decisions. PMID: 22082328 [PubMed - as supplied by publisher] (Source: Current Clinical Pharmacology)

Severity of community-acquired pneumonia treated with low-dose adjunctive corticosteroid

Critical Care — Tue, 08 Nov 2011 05:00:00 +0100

This study has succeeded to solve the problem that the choice and dose of antibiotics may have influenced the results. However, the authors should have considered the severity of CAP because adjunctive corticosteroid treatment should not be routinely administrated to patients with any severity of CAP. The target population for corticosteroid treatment should be clearly identified. In addition, the authors should consider lower doses and shorter periods of MPDN treatment in a future study. (Source: Critical Care)

[Correspondence] 5 versus 10 days of ceftriaxone for bacterial meningitis in children

LANCET — Sat, 05 Nov 2011 04:00:00 +0100

Elizabeth Molyneux and colleagues (May 28, p 1837) propose a shortened treatment course for specific types of bacterial meningitis. The goal of eliminating unnecessarily lengthy antibiotic treatment is laudable and a venture long overdue. However, for several practical reasons, these recommendations might be more applicable to high-income than to low-income countries. (Source: LANCET)

[Correspondence] 5 versus 10 days of ceftriaxone for bacterial meningitis in children – Authors' reply

LANCET — Sat, 05 Nov 2011 04:00:00 +0100

We agree with Stephen Obaro that short-course antibiotic therapy for bacterial meningitis is not new. Although we did our study in developing countries, we agree with him that stoppage of antibiotics after 5 days could be considered for developed countries where there are good laboratory facilities, early care-seeking, and low non-prescription use of antibiotics. (Source: LANCET)

Ceftriaxone Ameliorates Motor Deficits and Protects Dopaminergic Neurons in 6-Hydroxydopamine-Lesioned Rats

ACS Chemical Neuroscience — Fri, 04 Nov 2011 14:12:07 +0100

ACS Chemical NeuroscienceDOI: 10.1021/cn200072h (Source: ACS Chemical Neuroscience)

Ceftriaxone-Induced Hemolysis in a Child With Lyme Arthritis: A Case for Antimicrobial Stewardship

PEDIATRICS — Tue, 01 Nov 2011 04:00:00 +0100

We report here the case of a young girl treated with intravenous ceftriaxone who subsequently developed drug-induced autoimmune hemolytic anemia and renal failure. Her severe sequelae highlight the importance of antimicrobial stewardship. We review here the goals of antimicrobial stewardship and several strategies for achieving them. In addition, we briefly discuss the rare adverse drug event experienced by our patient. (Source: PEDIATRICS)

Acute urine retention induced by ceftriaxone.

Saudi Journal of Kidney Diseases and Transplantation — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Akl KF, Masri AT, Hjazeen MM Abstract Ceftriaxone is known to cause biliary pseudolithiasis and, rarely, nephrolithiasis. When used in neonates receiving intravenous calcium, fatal lung and kidney calcifications occur. There is no satisfactory explanation for the pseudolithiasis, and the mechanism of stone formation remains unknown. Herein, we report a child with acute urinary retention (AUR) secondary to ceftriaxone therapy. The AUR developed on the second hospital day. The urinary excretion of uric acid was elevated. In retrospect, there was a positive paternal family history of gout and stones. A positive family history of gout or stones is a pointer to the possibility of AUR or urolithiasis in patients on treatment with ceftriaxone. If urinary symptoms develop, it is w...

Renal abscess due to Escherichia coli in a child.

Saudi Journal of Kidney Diseases and Transplantation — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Baradkar VP, Mathur M, Kumar S Abstract Among the various intraabdominal abscesses, renal abscess is a rare entity, especially in children and accounts for a number of cases of "missed diagnoses." Drainage of pus and appropriate antibiotic therapy is the gold standard for treatment. Here we report a case of left renal abscess in a 6-year-old female child secondary to renal calculus. The patient presented with abdominal pain and mild fever for three months and the diagnosis was made by X-ray in the kidney, ureter and bladder (KUB) region, intravenous pyelography and ultrasonography of the abdomen. Escherichia coli was isolated from pus obtained by percutaneous drainage under sonographic guidance. The patient responded to intra-venous ceftriaxone, amikacin, and percutaneous ...

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Increased urinary calcium excretion caused by ceftriaxone: possible association with urolithiasis

Pediatric Nephrology — Fri, 28 Oct 2011 17:14:11 +0100

Abstract The administration of ceftriaxone is known to be associated with biliary pseudolithiasis, although the development of urolithiasis has only rarely been reported. We treated a young male with bacterial meningitis complicated by urinary precipitates composed of ceftriaxone–calcium salt, which prompted us to study whether ceftriaxone administration predisposes children to the formation of urinary precipitates. The case–control study reported here included 83 children with bacterial pneumonia aged from 3 months to 8.9 years. The children were divided into one group of 43 children who received ceftriaxone (group A) and a second group of 40 children who received amoxicillin (group B). Paired samples of serum and urine before and after treatment were obtaine...

Tuberculous meningitis together with systemic brucellosis

Journal of Infection and Chemotherapy — Fri, 28 Oct 2011 06:06:55 +0100

We present a case of a 57-year-old woman admitted with findings of meningitis. Cerebrospinal fluid (CSF) tests revealed a pleocytosis together with a low CSF glucose concentration. Empirically, antituberculosis treatment was started. Rose Bengal and Wright tests were performed to exclude brucellosis with central nervous system involvement. These tests were positive in serum but not in CSF. Antibrucellosis treatment with doxycycline and ceftriaxone was started without withdrawing the antituberculosis treatment because of the possibility of simultaneous infection with both tuberculosis and brucellosis agents. Finally, this approach was shown to be correct when tuberculosis was isolated from the culture of CSF. Clinicians in endemic regions for brucellosis should be careful while diagno...

Is Ceftriaxone-Induced Biliary Pseudolithiasis Influenced by UDP-Glucuronosyltransferase 1A1 Gene Polymorphisms?

Advances in Pharmacological Sciences — Wed, 26 Oct 2011 13:07:06 +0100

We describe 3 children with ceftriaxone-induced pseudolithiasis, who were also carriers of the A(TA)7TAA polymorphism of the UGT1A1 gene, implying that a cause and effect relation may exist. (Source: Advances in Pharmacological Sciences)

First Report of a Case of Pneumococcal Meningitis Which Did Not Respond to the Ceftriaxone Therapy despite the Isolated Organism Being Sensitive to This Antibiotic In Vitro

Clinical and Developmental Immunology — Wed, 26 Oct 2011 00:06:55 +0100

A 60-year-old man presented with pneumococcal meningitis which did not respond to the ceftriaxone therapy, in spite of in-vitro susceptibility (minimal inhibitory concentration of 0.016 μg/dLit) of the isolated organism to this antibacterial agent, although ceftriaxone is still the drug of choice for such pneumococcal meningitis. Review of published articles revealed no report of clinical resistance in organisms which were susceptible to the same antimicrobial agent in vitro. This alarming emergence of isolates with in vivo resistance should be considered and even could lead to a shift in the empirical antibiotic therapy for pneumococcal infections. (Source: Clinical and Developmental Immunology)

CEFTRIAXONE AND DEXTROSE (Ceftriaxone) Injection, Solution [B. Braun Medical Inc.]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Tue, 18 Oct 2011 05:00:00 +0100

Updated Date: Oct 18, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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CEFTRIAXONE SODIUMinjection, Powder, For Solution [Hospira, Inc]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Thu, 13 Oct 2011 05:00:00 +0100

Updated Date: Oct 13, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

CEFTRIAXONE SODIUMinjection, Powder, For Solution [Sandoz Inc]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Thu, 13 Oct 2011 05:00:00 +0100

Updated Date: Oct 13, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

CEFTRIAXONE SODIUMinjection, Powder, For Solution [Hospira, Inc]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Thu, 13 Oct 2011 05:00:00 +0100

Updated Date: Oct 13, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

CEFTRIAXONE SODIUMinjection, Powder, For Solution [Sandoz Inc]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Thu, 13 Oct 2011 05:00:00 +0100

Updated Date: Oct 13, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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UK national guideline for the management of gonorrhoea in adults, 2011

International Journal of STD and AIDS — Thu, 13 Oct 2011 04:00:00 +0100

The British Association for Sexual Health and HIV (BASHH) UK gonorrhoea guideline has been updated in 2011. It offers advice on diagnosis, treatment and health promotion for anogenital and pharyngeal gonorrhoea. Nucleic acid amplification tests (NAATs) are now being used more for diagnosis and are increasing detection rates in the pharynx and rectum. First line treatment using ceftriaxone with azithromycin is now advised, along with routine test of cure (TOC). The aim is to slow the spread of resistant gonorrhoea now that fewer antibiotics remain effective. A patient information leaflet has been developed. (Source: International Journal of STD and AIDS)

Amoxicillin/clavulanic acid/ceftriaxone: Kounis syndrome: 2 case reports

Reactions — Wed, 12 Oct 2011 06:03:59 +0100

(Source: Reactions)

Gonorrhea Becoming Harder To Treat, Cefixime Often No Good Any More

Health News from Medical News Today — Tue, 11 Oct 2011 06:00:00 +0100

Gonorrhea is becoming more and more drug resistant, UK authorities are warning. The Health Protection Agency, UK, says it will no longer recommend cefixime as the first choice of treatment because laboratory tests show it is becoming increasingly less effective. The Agency says there have been reports of treatment failure in patients on cefixime. Cefixime has been the most widely used antibiotic to treat gonorrhea during the last ten years. The HPA (Health Protection Agency) is now recommending doctors use a combination of ceftriaxone by injection along with oral azithromycin... (Source: Health News from Medical News Today)

Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP) report 2010

NeLM - News — Tue, 11 Oct 2011 04:00:00 +0100

Source: Health Protection Agency (HPA) Area: News The Health Protection Agency has published the 2010 GRASP (Gonococcal Resistance to Antimcrobials Surveillance Programme) report. This programme has monitored the trends and drifts in susceptibility in gonococcal isolates since 2000. It was this programme that informed a change in national guidelines in 2002 from ciprofloxacin, the antimicrobial agent of choice, to the third generation cephalosporins, cefixime and ceftriaxone. The GRASP report in 2009 gave worrying indications that there was a drift towards decreased susceptibility to these agents, particularly for cefixime, the oral agent that has been most widely used. In 2011, the first reports of treatment failures began to emerge both in England and in other European countries. &nbs...

WITHDRAWN: Azithromycin for treating uncomplicated typhoid and paratyphoid fever (enteric fever).

Cochrane Database of Systematic Reviews — Tue, 11 Oct 2011 01:20:04 +0100

CONCLUSIONS: Azithromycin appears better than fluoroquinolone drugs in populations that included participants with drug-resistant strains. Azithromycin may perform better than ceftriaxone. PMID: 21975751 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

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Fluoroquinolones for treating typhoid and paratyphoid fever (enteric fever).

Cochrane Database of Systematic Reviews — Tue, 11 Oct 2011 01:20:04 +0100

CONCLUSIONS: Generally, fluoroquinolones performed well in treating typhoid, and maybe superior to alternatives in some settings. However, we were unable to draw firm general conclusions on comparative contemporary effectiveness given that resistance changes over time, and many studies were small. Policy makers and clinicians need to consider local resistance patterns in choosing a fluoroquinolone or alternative.There is some evidence that the newest fluoroquinolone, gatifloxacin, remains effective in some regions where resistance to older fluoroquinolones has developed. However, the different fluoroquinolones have not been compared directly in trials in these settings. PMID: 21975746 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

Glutamate transporter subtype 1 (GLT-1) activator ceftriaxone attenuates amphetamine-induced hyperactivity and behavioral sensitization in rats

Drug and Alcohol Dependence — Sat, 08 Oct 2011 15:01:19 +0100

Conclusion: The present demonstration that ceftriaxone attenuates amphetamine-induced hyperactivity and behavioral sensitization suggests its documented efficacy against adverse cocaine and morphine effects extends to amphetamine. (Source: Drug and Alcohol Dependence)

Urinary Tract Infections in the Early Posttransplant Period After Kidney Transplantation: Etiologic Agents and Their Susceptibility

Transplantation Proceedings — Sat, 01 Oct 2011 04:00:00 +0100

Conclusion: Our study showed predominantly Gram-negative rods from the Enterobacteriaceae family comprising (84.8%) of Gram-negative isolates: 52.5% ESBL and resistant enterococci (87.5%) in Gram-positive isolates. The increased proportion of isolates of multi-drug–resistant bacterial agents which can cause severe UTIs may be due to our frequent use of ceftriaxone for perioperative bacterial prophylaxis. (Source: Transplantation Proceedings)

Reply

Journal of Pediatric Surgery — Sat, 01 Oct 2011 04:00:00 +0100

We appreciate the comments raised by Drs Makin and Davenport and their concern for a group of children whose management can be quite vexing. The intent of our series was to describe patients for whom endoscopic ultrasound (EUS) illuminated a challenging diagnosis and for whom laparoscopic cholecystectomy provided effective therapy. We did not intend to establish the legitimacy of microlithiasis as a novel diagnosis in children as other authors have previously done so . Neither did we intend to account for the reasons underlying the formation of these microliths. Traditional gallstones may arise from several different underlying etiologies, whether cholesterol, pigment, infection, or ceftriaxone for that matter. Regardless of the etiology of the gallstones, they may present with similar sym...

Phenotypic and genotypic properties of Neisseria gonorrhoeae isolates in Norway in 2009: antimicrobial resistance warrants an immediate change in national management guidelines

European Journal of Clinical Microbiology and Infectious Diseases — Fri, 30 Sep 2011 06:24:43 +0100

Abstract Despite rapidly diminishing treatment options for Neisseria gonorrhoeae and high levels of ciprofloxacin resistance worldwide, Norwegian guidelines still recommend ciprofloxacin as empirical treatment for gonorrhea. The present study aimed to characterize phenotypical and genotypical properties of N. gonorrhoeae isolates in Norway in 2009. All viable N. gonorrhoeae isolates (n = 114) from six university hospitals in Norway (2009) were collected, representing 42% of all notified gonorrhea cases. Epidemiological data were collected from the Norwegian Surveillance System for Communicable Diseases and linked to phenotypical and genotypical characteristics for each N. gonorrhoeae isolate. Resistance levels to the antimicrobials examined were: ciprofloxacin 78%, azithr...

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A Foreign Body in the Anal Canal

Journal of Pakistan Medical Students — Fri, 30 Sep 2011 04:00:00 +0100

Authors: Saeed Shoar1, 2, 3 M.D., Zhamak Khorgami1 M.D. Affiliations: 1 Department of surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran 2 Developmental Association for Clinical Study (DACS), Tehran University of Medical Sciences, Tehran, Iran 3 Student Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran Correspondence to: Saeed Shoar, M.D., Developmental Association for Clinical Study (DACS), Student Scientific Research Center (SSRC), Tehran University of Medical Sciences (SSRC), Tehran, Iran Email: saeedshoar@gmail.com Conflicting Interest: None declared Funding Sources: None Declared Article submitted on: 21st July, 2011 Accepted on: 22ed July, 2011 This clinical image has been peer reviewed Clinic...

CEFTRIAXONE SODIUMinjection, Powder, For Solution [Hospira, Inc]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Thu, 29 Sep 2011 05:00:00 +0100

Updated Date: Sep 29, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

CEFTRIAXONE SODIUMinjection, Powder, For Solution [Sandoz Inc]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Thu, 29 Sep 2011 05:00:00 +0100

Updated Date: Sep 29, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Homozygous carrier of the NOD2 1007fs frame‐shift mutation presenting with refractory community‐acquired spontaneous bacterial peritonitis and developing fatal pulmonary mucormycosis: A case report

Hepatology Research — Mon, 26 Sep 2011 15:04:47 +0100

Genetic variants of the innate immune system contribute to episodes of spontaneous bacterial peritonitis (SBP) in patients with cirrhosis. We herein report the case of a patient with the homozygous nucleotide‐binding oligomerization domain containing 2 (NOD2) frame‐shift mutation 1007fs presenting with sepsis and community‐acquired SBP by Escherichia coli. Secondary peritonitis, pancreatic ascites and malignant causes were excluded by extensive diagnostic work‐up. First‐line treatment with ceftriaxone was not successful despite in vitro sensitivity of the isolated strain. Despite prolonged second‐line treatment with imipenem/cilastatin and intermittent ascites drainage, the ascitic fluid neutrophil count remained markedly elevated in this patient. In the course of the disease t...

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Synthesis, characterization and antimicrobial activity of novel ethyl 1-(N-substituted)-5-phenyl-1H-pyrazole-4-carboxylate derivatives

Medicinal Chemistry Research — Thu, 22 Sep 2011 06:39:03 +0100

Abstract In the present study, a novel series of Pyrazole derivatives (3a–m) were synthesized by condensing ethyl-3-(dimethylamino)-2-(phenylcarbonyl)prop-2-enoate with different aromatic and aliphatic hydrazines. These newly synthesized compounds were characterized by NMR, mass spectral, IR spectral studies as well as by C, H, and N analyses. All the newly synthesized compounds were screened for their antibacterial properties against Staphylococcus aureus, Bacillus subtilis, Escherichia coli, and Pseudomonas aeruginosa. Among the screened samples, 3c, 3f, 3k, and 3l have showed excellent antibacterial activity against all the tested bacterial strains as compared to the standard drug Ceftriaxone. Few of the compounds were found to be biologically potent. Molecular structur...

Asymptomatic Bacteriuria in children with sickle cell anemia at The University of Nigeria Teaching Hospital, Enugu, South East, Nigeria.

Italian Journal of Pediatrics — Mon, 19 Sep 2011 04:00:00 +0100

Conclusion: The risk of asymptomatic bacteriuria is three times more common in children with sickle cell anemia than in children with normal haemoglobin. It is therefore important to screen SCA patients, especially the females for UTI and when positive, they should be treated according to the sensitivity result of the cultured organisms. (Source: Italian Journal of Pediatrics)

Ceftriaxone: Gallstone in a child: case report

Reactions — Sun, 18 Sep 2011 23:35:47 +0100

(Source: Reactions)

Increasing Trend of Resistance to Penicillin, Tetracycline, and Fluoroquinolone Resistance in Neisseria gonorrhoeae from Pakistan (1992–2009)

Computational Intelligence and Neuroscience — Thu, 15 Sep 2011 15:32:33 +0100

Emergence and spread of drug resistant Neisseria gonorrhoeae is global concern. We evaluated trends of antimicrobial resistance in Neisseria gonorrhoeae over years 1992–2009 in Pakistan. Resistance rates were compared between years (2007–2009) and (1992–2006). Antimicrobial susceptibility testing was performed and interpreted according to Clinical Laboratory Standards Institute (CLSI) criteria using the disk diffusion methodology against penicillin, ceftriaxone, tetracycline and ofloxacin. Additional antibiotics tested in 100 strains isolated during 2007–2009, included cefotaxime, cefoxitin, cefuroxime, cefipime, ceftazidime, ceftizoxime, cefixime, cefpodoxime, spectinomycin and azithromycin. Neisseria gonorrhoeae ATCC 49226 was used as control. Chi-square for trend...

Approach to septic arthritis.

American Family Physician — Thu, 15 Sep 2011 04:00:00 +0100

Authors: Horowitz DL, Katzap E, Horowitz S, Barilla-Labarca ML Abstract Prompt diagnosis and treatment of infectious arthritis can help prevent significant morbidity and mortality. The acute onset of monoarticular joint pain, erythema, heat, and immobility should raise suspicion of sepsis. Constitutional symptoms such as fever, chills, and rigors are poorly sensitive for septic arthritis. In the absence of peripheral leukopenia or prosthetic joint replacement, synovial fluid white blood cell count in patients with septic arthritis is usually greater than 50,000 per mm3. Isolation of the causative agent through synovial fluid culture is not only definitive but also essential before selecting antibiotic therapy. Synovial fluid analysis is also useful to help distinguish crystal arthr...

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Ambulatory intravenous ceftriaxone in paediatric A&E: a useful alternative to hospital admission?

Emergency Medicine Journal — Wed, 14 Sep 2011 04:00:00 +0100

Conclusions Parental opinion favours ambulatory treatment, with 94% of parents acknowledging they would choose it again in similar circumstances. Cost analysis favours ambulatory treatment based on predicted costs of a similar length of inpatient stay. (Source: Emergency Medicine Journal)

Pregnant women with erythema migrans and isolation of borreliae from blood: course and outcome after treatment with ceftriaxone

Diagnostic Microbiology and Infectious Disease — Wed, 14 Sep 2011 04:00:00 +0100

Abstract: The course and outcome in 7 pregnant European women with erythema migrans and borreliae isolated from blood, treated with intravenous ceftriaxone for 14 days, were uneventful, and the outcome of their pregnancies was good. Spirochetemia was not associated with constitutional symptoms. (Source: Diagnostic Microbiology and Infectious Disease)

Impact of adopting minimum inhibitory concentration as the determinant of susceptibility to cephalosporins and carbapenems in multi-drug resistant Enterobacteriaceae

European Journal of Clinical Microbiology and Infectious Diseases — Mon, 12 Sep 2011 15:53:03 +0100

Abstract The Clinical and Laboratory Standards Institute has recommended that Enterobacteriaceae susceptibility to most cephalosporins and carbapenems be reported according to minimum inhibitory concentration (MIC) alone. We analyzed our record of multi-drug resistant Enterobacteriaceae to assess the impact of these changes. We compared susceptibilities of ceftriaxone-resistant Enterobacteriaceae when using the 2009 and new 2010 MIC standards. Vitek2® (BioMerieux), was used to assess the changes in susceptibility. Klebsiella pneumoniae, Proteus sp., and Escherichia coli were the major species from urine, sputum, blood, and other sterile sites. The new breakpoint for cephalosporins increased resistance in E. coli and P. mirabilis. Many Proteus categorized as resistant by ex...

Acute generalized exanthematous pustulosis after ceftriaxone use resembling sepsis

Journal of Infection and Chemotherapy — Mon, 12 Sep 2011 15:52:58 +0100

We report a case of ceftriaxone-induced acute generalized exanthematous pustulosis that presented with the appearance of sepsis. After discontinuation of ceftriaxone, the findings were improved. Content Type Journal ArticleCategory Case ReportPages 1-3DOI 10.1007/s10156-011-0297-zAuthors Abdurrahman Kaya, Department of Infectious Disease, Medical School of Cerrahpasa, Istanbul University, Istanbul, TurkeySibel Yıldız, Department of Infectious Disease, Medical School of Cerrahpasa, Istanbul University, Istanbul, Turkeyİlker İnanc Balkan, Department of Infectious Disease, Medical School of Cerrahpasa, Istanbul University, Istanbul, TurkeyHayyam Eyvazov, Department of Internal Medicine, Medical School of Cerrahpasa, Istanbul University, Istanbul, TurkeyIsıl Bavunoglu, Department ...

[Case Report] Sepsis and spontaneous bacterial peritonitis in Thailand

LANCET — Fri, 02 Sep 2011 23:00:00 +0100

In June, 2007, a 66-year-old man (case 1), an alcohol misuser with alcoholic liver cirrhosis who habitually ate raw pork, was referred to Uttaradit Hospital, northern Thailand. He had a fever and massive ascites. His leucocyte count was 4·4×109/L, and total bilirubin and albumin concentrations were 23·7 mg/L, and 26 g/L, respectively. Polymorphonuclear leucocyte count of ascitic fluid was 4·1×108/L and culture was positive despite a negative blood culture. This patient was diagnosed with spontaneous bacterial peritonitis, and successfully treated with ceftriaxone. (Source: LANCET)

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Diagnosis and treatment of acute pyelonephritis in women.

American Family Physician — Thu, 01 Sep 2011 04:00:00 +0100

Authors: Colgan R, Williams M, Johnson JR Abstract Acute pyelonephritis is a common bacterial infection of the renal pelvis and kidney most often seen in young adult women. History and physical examination are the most useful tools for diagnosis. Most patients have fever, although it may be absent early in the illness. Flank pain is nearly universal, and its absence should raise suspicion of an alternative diagnosis. A positive urinalysis confirms the diagnosis in patients with a compatible history and physical examination. Urine culture should be obtained in all patients to guide antibiotic therapy if the patient does not respond to initial empiric antibiotic regimens. Escherichia coli is the most common pathogen in acute pyelonephritis, and in the past decade, there has been an i...

Prevalence, Characterization, and Antimicrobial Resistance of Aeromonas Strains from Various Retail Food Products in Mumbai, India

Journal of Food Science — Thu, 01 Sep 2011 04:00:00 +0100

Abstract: A total of 154 food samples (chicken, fish, and ready‐to‐eat sprouts) from various retail outlets in Mumbai, India, were analyzed for the presence of Aeromonas spp. over a period of 2 y (January 2006 to March 2008). Twenty‐two Aeromonas isolates belonging to 7 different species were isolated from 18 (11.7%) food samples. The highest percentages of isolation were from chicken (28.6%) followed by fish (20%) and sprout (2.5%) samples. Aeromonas caviae, A. veronii bv. sobria, and A. salmonicida were the most frequently isolated species from sprouts, chicken, and fish samples, respectively. The genes encoding for putative virulence factors, cytotoxic enterotoxin (act), hemolysin (hly), aerolysin (aer), elastase (ahyB), and lipase (lip) were detected using ...

Serratia Ficaria isolated from sputum specimen.

Acta Microbiologica et Immunologica Hungarica — Thu, 01 Sep 2011 04:00:00 +0100

Authors: Gul M, Dogan E, Kirecci E, Ucmak H, Dirican E, Karadag A Abstract Serratia ficaria was first described in 1979 as a Gram-negative facultative anaerobic rod. S. ficaria was found in figs, but also isolated from human specimens in a few cases. We now report an isolate of S. ficaria from sputum specimen.A 46-year-old man was suffering from a chronic renal failure of five years, four months of peritoneal dialysis and one week of fever due to respiratory tract infection, accompanied by cough. Sputum culture yielded a Gram-negative rod. It was identified as S. ficaria and the antibiotic susceptibility test was performed by automated Vitek II (bioMerieux). The tested S. ficaria strain was susceptible to amikacin, gentamicin, cefepime, trimethoprim-sulfamethoxazole, imipenem, mero...

T137 anti-allodynic and anti-hyperalgesic effects of ceftriaxone in streptozocin-induced diabetic rats

European Journal of Pain Supplements — Thu, 01 Sep 2011 04:00:00 +0100

(Source: European Journal of Pain Supplements)

Tropheryma whipplei aortic valve endocarditis without systemic Whipple's disease

International Journal of Infectious Diseases — Wed, 31 Aug 2011 04:00:00 +0100

We present the case of a 48-year-old male with Whipple's endocarditis of the aortic valve who did not develop signs of systemic Whipple's disease. Our patient was treated with a regimen that included ceftriaxone for 6 weeks prior to his cardiac surgery, yet valve pathology demonstrated abundant T. whipplei, suggesting that a prolonged antibiotic course is necessary for the treatment of Whipple's endocarditis. (Source: International Journal of Infectious Diseases)

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Serologic characteristics of ceftriaxone antibodies in 25 patients with drug-induced immune hemolytic anemia.

Transfusion — Tue, 30 Aug 2011 23:00:00 +0100

CONCLUSION: Ceftriaxone antibodies can cause severe intravascular hemolysis. Complement can usually be detected on the patient's RBCs and IgM antibodies are usually detected in the patient's serum. PMID: 21880048 [PubMed - as supplied by publisher] (Source: Transfusion)

Ceftriaxone/vancomycin: Linear IgA bullous dermatosis: case report

Reactions — Mon, 29 Aug 2011 14:09:06 +0100

(Source: Reactions)

Microbiological profile with antibiotic sensitivity pattern of cholesteatomatous chronic suppurative otitis media among children

International Journal of Pediatric Otorhinolaryngology — Sat, 27 Aug 2011 16:00:41 +0100

Conclusion: Continuous and periodic evaluation of microbiological pattern and antibiotic sensitivity of cholesteatomatous CSOM is necessary to decrease the potential risks of complications by early institution of appropriate systemic and topical antibiotic alongside mastoid exploration. We believe that our data may contribute to an effective medical management of chronic suppurative otitis media with cholesteatoma. Since the most common organisms in our clinical set up being P. aeruginosa, P. mirabilis and S. aureus, which showed a percentage susceptibility of 100% to ceftazidime and vancomycin, thus making it an empirical antibiotic combination therapy of choice in the recent times. (Source: International Journal of Pediatric Otorhinolaryngology)

Elevated International Normalized Ratio values associated with concomitant use of warfarin and ceftriaxone.

American Journal of Health-System Pharmacy : AJHP — Fri, 26 Aug 2011 23:00:38 +0100

Conclusion A 67-year-old American Indian woman with previously stable INR values during long-term warfarin therapy after mitral valve replacement surgery had INR elevations on two occasions after receiving ceftriaxone for urinary tract infections. PMID: 21856805 [PubMed - in process] (Source: American Journal of Health-System Pharmacy : AJHP)

Clonality behind the increase of multidrug-resistance among non-invasive pneumococci in Southern Finland

European Journal of Clinical Microbiology and Infectious Diseases — Thu, 25 Aug 2011 15:49:20 +0100

Abstract Multidrug-resistance among Streptococcus pneumoniae isolates, especially of serotype 19A, has increased in several countries recently. Even before the introduction of the pneumococcal conjugate vaccine into the Finnish National Vaccination Programme, the proportion of multidrug-resistant (MDR) pneumococci had doubled from 2007 to 2008, when it reached 3.6% in Southern Finland. Our aim was to look for a possible association between antimicrobial susceptibility and clonality among the MDR isolates. Twelve non-invasive isolates non-susceptible to penicillin, erythromycin, clindamycin, trimethoprim/sulfamethoxazole, and doxycycline from 2008 were available for serotyping, genotyping by multilocus sequence typing (MLST), and detection of genes encoding macrolide resista...

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CEFTRIAXONE (Ceftriaxone Sodium) Injection, Powder, For Solution [APP Pharmaceuticals, LLC]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Wed, 24 Aug 2011 05:00:00 +0100

Updated Date: Aug 24, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Single-Agent, Broad-Spectrum Fluoroquinolones for the Outpatient Treatment of Low-Risk Febrile Neutropenia (September).

The Annals of Pharmacotherapy — Mon, 22 Aug 2011 23:00:00 +0100

CONCLUSIONS: Use of oral, single-agent, broad-spectrum fluoroquinolones for outpatient treatment of FN in low-risk patients has shown promising results. At this time, this type of therapy should be limited to low-risk patients. Future clinical trials should include larger sample sizes and a comparison with existing first-line oral therapy-oral ciprofloxacin plus amoxicillin/clavulanate. PMID: 21862714 [PubMed - as supplied by publisher] (Source: The Annals of Pharmacotherapy)

Antibiotics for preventing meningococcal infections.

Cochrane Database of Systematic Reviews — Sat, 20 Aug 2011 17:00:05 +0100

CONCLUSIONS: Using rifampin during an outbreak may lead to the circulation of resistant isolates. Use of ciprofloxacin, ceftriaxone or penicillin should be considered. All four agents were effective for up to two weeks follow up, though more trials comparing the effectiveness of these agents for eradicating N. meningitidis would provide important insights. PMID: 21833949 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

Anaphylactoid reaction to facial adder bite

Archives of Disease in Childhood — Wed, 10 Aug 2011 23:00:00 +0100

A previously well 3-year-old boy was playing outside. His father found him holding aloft a snake recognisable as an adder, which was coiling around both forearms. He said "look" and the snake struck and bit him twice on the face (figure 1). The snake was thrown to the ground, but the boy did not express pain or distress. He was rushed to the local medical centre and on admission he was vomiting, wheezy and tachypnoeic with facial swelling. His general practitioner gave epinephrine and chlorpheniramine and transferred him immediately to a hospital. He was tachycardic (170 bpm), obtunded (Glasgow Coma Scale 10) and poorly perfused. A venous blood gas showed pH 7.23, pCO2 6.68 KPa, HCO3– 18 mmol/l, base excess –7.2 and lactate 4.4 mmol/l. Antivenom, ceftriaxone, tetanus vaccinatio...

Which antibiotic first in meningococcal disease? A national survey

Archives of Disease in Childhood — Wed, 10 Aug 2011 23:00:00 +0100

In response to reports of deaths involving calcium–ceftriaxone precipitates in neonates and young infants,1 The Medicines and Healthcare Products Regulatory Agency in the UK has warned that ceftriaxone should not be used with calcium-containing solutions and is contraindicated entirely in neonates.2 Draft guidelines on the management of meningococcal disease by The National Institute for Health and Clinical Excellence available online recommend avoiding ceftriaxone at the same time as calcium infusions and caution against use in the under 3-month age group.3 We performed an anonymised postal survey from July to November 2009, of all hospitals in England and Wales with an acute, inpatient general paediatric unit about their existing antibiotic guidelines for treatment of suspected men...

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Prevalence, Characterization, and Antimicrobial Resistance of Aeromonas Strains from Various Retail Food Products in Mumbai, India

Journal of Food Science — Sun, 07 Aug 2011 23:00:00 +0100

Ceftiofur Use in Finishing Swine Barns and the Recovery of Fecal Escherichia coli or Salmonella spp. Resistant to Ceftriaxone

Foodborne Pathogens and Disease — Fri, 05 Aug 2011 16:01:36 +0100

Foodborne Pathogens and Disease , Vol. 0, No. 0. (Source: Foodborne Pathogens and Disease)

Genotyping of two Neisseria gonorrhoeae fluroquinolone-resistant strains in the Brazilian Amazon Region.

Memorias do Instituto Oswaldo Cruz — Mon, 01 Aug 2011 04:00:00 +0100

We report two ciprofloxacin and ofloxacin-resistant Neisseria gonorrhoeae strains that were isolated from the urethral discharge of male patients at the sexually transmitted diseases outpatient clinic of the Alfredo da Matta Foundation (Manaus, state of Amazonas, Brazil). The gonococci displayed minimal inhibitory concentrations (> 32.00 µg/mL) and three mutations in the quinolone resistance-determining region (S91F and D95G in GyrA and S87R in ParC). Both isolates were genotyped using N. gonorrhoeae multi-antigen sequence typing and the analysis showed that the ST225 which represented an emerging widespread multi-resistant clone that has also been associated with reduced susceptibility to ceftriaxone. We recommend continued surveillance of this pathogen to assess the efficacy of anti-...

Fulminant hepatitis in typhoid fever

Journal of Infection and Public Health — Sun, 31 Jul 2011 23:00:00 +0100

Conclusion: The association of typhoid fever with hepatitis A can result in fulminant hepatitis but in this case, is associated with complete recovery. (Source: Journal of Infection and Public Health)

Ceftriaxone prevents the induction of cocaine sensitization and produces enduring attenuation of cue- and cocaine-primed reinstatement of cocaine-seeking.

Behavioural Brain Research — Fri, 29 Jul 2011 23:00:00 +0100

Authors: Sondheimer I, Knackstedt LA Ceftriaxone is a beta-lactam antibiotic which has been found to increase the expression and function of the major glutamate transporter, GLT-1. It has previously been shown that GLT-1 expression is decreased in the nucleus accumbens following cocaine self-administration and extinction training; ceftriaxone given in the days immediately prior to reinstatement testing attenuates both cue- and cocaine-primed reinstatement. Here we tested the ability of ceftriaxone pre-treatment (for 5 days prior to the first cocaine exposure) to prevent the induction of cocaine sensitization and the acquisition of cocaine self-administration. We also tested whether ceftriaxone administered only during self-administration attenuates the reinstatement of extinguished coc...

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Moxarella Lacunate Endocarditis

Australasian Medical Journal - AMJ — Fri, 22 Jul 2011 09:44:45 +0100

We describe a case of infective endocarditis due to Moraxella lacunata involving the native mitral and aortic valves, complicated by cerebral emboli and resultant hemiparesis. The patient was treated with ceftriaxone and gentamicin and improved. This is the first case reported in medical literature of native multivalvular endocarditis produced by this rare organism. (Source: Australasian Medical Journal - AMJ)

Clinical significance and antimicrobial susceptibilities of Aerococcus sanguinicola and Aerococcus urinae

Diagnostic Microbiology and Infectious Disease — Fri, 22 Jul 2011 00:43:52 +0100

In conclusion, A. sanguinicola and A. urinae are not infrequent causes of urinary tract infection and most A. sanguinicola isolates have elevated MICs to levofloxacin. (Source: Diagnostic Microbiology and Infectious Disease)

Cholestatic hepatitis with intravenous ceftriaxone

Indian Journal of Pharmacology — Thu, 21 Jul 2011 23:00:00 +0100

Inderpal Kaur, Jatinder SinghIndian Journal of Pharmacology 2011 43(4):474-475Drug-induced liver injury is a major health problem. Its predominant forms include acute hepatitis, cholestasis, and a mixed pattern. Ceftriaxone is a third-generation cephalosporin and is widely used in the postoperative period due to its wider spectrum, longer half-life, and better tissue penetrability. Earlier cases of high aminotransferase levels and hepatitis have also been reported with the use of ceftriaxone. Here we report a case of cholestatic hepatitis with intravenous ceftriaxone. (Source: Indian Journal of Pharmacology)

Posterior syphilitic uveitis: clinical characteristics, co-infection with HIV, response to treatment

Japanese Journal of Ophthalmology — Wed, 13 Jul 2011 06:18:30 +0100

Conclusions In this series, syphilitic posterior uveitis presented only in men, and all with available data were MSM. The majority were concomitantly infected with HIV. Clinical presentations varied and all patients demonstrated either significant improvement or complete resolution of inflammation. Content Type Journal ArticlePages 1-9DOI 10.1007/s10384-011-0053-zAuthors Sing Your Li, Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, 1855 W. Taylor Street, Chicago, IL 60612, USAAndrea D. Birnbaum, Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, 1855 W. Taylor Street, Chicago, IL 60612, USAHoward H. Tessler, Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, 1855 W....

New gonorrhoea strain resists drugs

NHS News Feed — Tue, 12 Jul 2011 17:00:00 +0100

Doctors have found a new ‘superbug’ form of gonorrhoea’ that is resistant to a range of antibiotics, it has been announced. Several newspapers have reported on the first case of the strain, which was recently discovered in a Japanese woman. Testing has shown that the strain has resistance against a range of antibiotic drugs, including those commonly used to cure the sexually transmitted infection. The strain, called H041, was investigated by a Swedish research team lead by Dr Magnus Unemo from the Swedish Institute for Infectious Disease Control. Dr Unemo reportedly told the Daily Mirror that “the drug-resistant strain could spread around the world in 10 years”. Researchers are now trying to understand why this strain is resistant to existing treatments and how to stop it from sp...

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Drug induced immune haemolytic anaemia in the Berlin Case‐Control Surveillance Study

British Journal of Haematology — Mon, 11 Jul 2011 23:00:00 +0100

This study investigated the possibility of drug aetiology of immune haemolytic anaemia (IHA) in 134 patients with new onset of IHA who were identified in the Berlin Case‐Control Surveillance Study between 2000 and 2009. Single drugs related to IHA in three or more patients and assessed more than once as a certain or probable cause of IHA in a standardized causality assessment included diclofenac, fludarabine, oxaliplatin, ceftriaxone and piperacillin. In a case‐control study including all 124 IHA cases developed in outpatient care and 731 controls, significantly increased odds ratios (OR) were observed for beta‐lactam antibiotics (OR = 8·8; 95% confidence interval [CI] 3·2–25·2), cotrimoxazole (OR = 6·5; CI 1·1–37·9), ciprofloxacin (OR = 6·9, CI 1·3–38·5), ...

Cephalosporin Susceptibility Among Neisseria gonorrhoeae Isolates --- United States, 2000--2010.

MMWR Morb Mortal Wkl... — Thu, 07 Jul 2011 23:00:00 +0100

This report summarizes trends in cephalosporin susceptibility among N. gonorrhoeae isolates in the United States during 2000--2010 using data from the Gonococcal Isolate Surveillance Project (GISP). During that period, the percentage of isolates with elevated minimum inhibitory concentrations (MICs) to cephalosporins (≥0.25 µg/mL for cefixime and ≥0.125 µg/mL for ceftriaxone) increased from 0.2% in 2000 to 1.4% in 2010 for cefixime and from 0.1% in 2000 to 0.3% in 2010 for ceftriaxone. Although cephalosporins remain an effective treatment for gonococcal infections, health-care providers should be vigilant for treatment failure and are requested to report its occurrence to state and local health departments. State and local public health departments should promote maintenance of labor...

Factors associated with outcome and duration of therapy in outpatient parenteral antibiotic therapy (OPAT) patients with skin and soft-tissue infections

International Journal of Antimicrobial Agents — Thu, 07 Jul 2011 23:00:00 +0100

This study was designed to identify factors associated with adverse outcomes and increased duration of parenteral therapy in patients with skin and soft-tissue infections (SSTIs) managed with outpatient parenteral antibiotic therapy (OPAT). A retrospective cohort study interrogating variables recorded prospectively in an electronic OPAT patient database was performed. ‘OPAT failure’ was defined as hospitalisation following initiation of OPAT, or adverse event or progression of infection necessitating a change in antibiotic therapy. Variables associated with failure or increased duration of therapy were identified via univariate and multiple logistic regression analyses. In total, 963 first patient episodes of OPAT-treated SSTIs were observed; 84% were treated with daily ceftriaxone and...

A Clinical Pathway for Community-Acquired Pneumonia: An Observational Cohort Study

BMC Infectious Diseases — Tue, 05 Jul 2011 23:00:00 +0100

Background: Six hospitals instituted a voluntary, system-wide, pathway for community acquired pneumonia (CAP). We proposed this study to determine the impact of pathway antibiotics on patient survival, hospital length of stay (LOS), and total hospital cost. Methods: Data were collected for adults from six U.S. hospitals with a principal CAP discharge diagnosis code, a chest infiltrate, and medical notes indicative of CAP from 2005-2007. Pathway and non-pathway cohorts were assigned according to antibiotics received within 48 hours of admission. Pathway antibiotics included levofloxacin 750mg monotherapy or ceftriaxone 1000mg plus azithromycin 500mg daily. Multivariable regression models assessed 90-day mortality, hospital LOS, total hospital cost, and total pharmacy cost. Results: Overall,...

BASHH UK guideline for the management of epididymo-orchitis, 2010

International Journal of STD and AIDS — Mon, 04 Jul 2011 23:00:00 +0100

The BASHH UK guideline for the management of epididymo-orchitis has been updated in 2010. Consideration should be made of the changing potential aetiologies of epididymo-orchitis – mumps in non-immune individuals and tuberculosis in the immunocompromised and men from countries of high prevalence. The treatment of sexually acquired epididymo-orchitis has changed given the high levels of quinolone-resistant gonorrhoea such that ceftriaxone and doxycycline are recommended in those at high risk of gonorrhoea and doxycycline or ofloxacin in those patients where gonorrhoea is considered unlikely (negative microscopy for Gram-negative intracellular diplococci and no risk factors for gonorrhoea identified). A clinical care pathway has also been produced to simplify the management of epididym...

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Ceftriaxone: Thrombocytopenia in a child: case report

Reactions — Sun, 03 Jul 2011 18:34:01 +0100

(Source: Reactions)

Ceftriaxone: Vitamin K deficiency in an infant: case report

Reactions — Sun, 03 Jul 2011 18:34:01 +0100

(Source: Reactions)

Significance of Gram's stain smear, potassium hydroxide mount, culture, and microscopic pathology in the diagnosis of acrodermatitis continua of Hallopeau.

Skinmed — Fri, 01 Jul 2011 04:00:00 +0100

Authors: Sehgal VN, Sharma S Abstract A 21-year-old housewife presented to the authors' clinic in 2009 with recurrent papulovesicular and pustular eruptions on the index an ring fingers of the left hand accompanied by throbbing pain that had been active for the past 10 years. The condition did not respond to topical and/or systemic treatment. There was neither a personal/family history of psoriasis nor any other systemic disease. The sk surface of the patient's left hand was marked by the presence of multiple pustules located over an erythematous background, affecting th ring and adjoining middle fingers, with crusting prominent in places along the tips (Figure 1). Gram-stained smears prepared from th purulent specimen revealed Gram-positive cocci in clusters. Potassium hydroxide (...

Pathology Consultation on Drug-Induced Hemolytic Anemia.

American Journal of Clinical Pathology — Thu, 30 Jun 2011 15:46:13 +0100

Authors: Pierce A, Nester T, Drug-induced immune hemolytic anemia is considered to be rare but is likely underrecognized. The consulting pathologist plays a critical role in integrating serologic findings with the clinical history, as drug-induced antibodies should be distinguished as either drug-dependent or drug-independent for appropriate clinical management. Drug-dependent antibodies (DDABs) are most commonly associated with cefotetan, ceftriaxone, and piperacillin, whereas fludarabine, methyldopa, β-lactamase inhibitors, and platinum-based chemotherapeutics are frequent causes of drug-independent antibodies (DIABs). DDABs usually demonstrate a positive direct antiglobulin test and a negative elution, while DIABs are serologically indistinguishable from warm autoantibodies and ar...

Waterhouse-Friderichsen syndrome in an adult patient with meningococcal meningitis

Indian Journal of Dermatology — Wed, 29 Jun 2011 23:00:00 +0100

Alka Sonavane, Vasant Baradkar, Parul Salunkhe, Simit KumarIndian Journal of Dermatology 2011 56(3):326-328Waterhouse-Friderichsen syndrome is one of the fatal complications of meningococcal infection. Here we report a fatal case of this syndrome due to Neisseria meningitidis in a 29-year-old male patient who was admitted with high-grade fever and chills and vomiting since 7 days, a skin rash over the abdomen and trunk, and altered sensorium since 2 days. On examination, the signs of meningitis were present along with the hemorrhagic rash. The diagnosis of adrenal hemorrhage was confirmed by computerized tomographic scan findings. The patient was started on intravenous ceftriaxone, and the cerebrospinal fluid was processed for bacterial culture, which yielded growth of N meningitidis. The ...

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Ceftriaxone: Biliary pseudolithiasis: case report

Reactions — Mon, 27 Jun 2011 18:24:12 +0100

(Source: Reactions)

Multiple-locus variable number of tandem repeats (VNTR) fingerprinting (MLVF) and antibacterial resistance profiles of extended spectrum beta lactamase (ESBL) producing Pseudomonas aeruginosa among burnt patients in Tehran

Burns : Journal of the International Society for Burn Injuries — Mon, 27 Jun 2011 04:00:00 +0100

Abstract: Extended spectrum β-lactamase (ESBL)-producing trait was present in 48 out of the 112 (42.8%) Pseudomonas aeruginosa isolates collected from burn wound infections during a 12-month period. The presence of oxa-10, per-1, veb-1 and ges genes and the multiple-locus variable number of tandem repeats (VNTR) fingerprinting (MLVF) of 112 P. aeruginosa strains were determined by PCR and multiplex PCR. Disk diffusion methods were used to determine the susceptibility of the isolates to antimicrobial agents as instructed by CLSI. All ESBL isolates were resistant to aztreonam, cefepime, cefotaxime, cefpodoxime, ceftazidime, ceftriaxone and ofloxacin. Fewer than 60% of ESBL isolates were resistant to imipenem, meropenem, and piperacillin-tazobactam but more than 90% were resistant to amikaci...

Yokenella regensburgei in an immunocompromised host: a case report and review of the literature

Infection — Fri, 24 Jun 2011 15:58:41 +0100

Abstract Yokenella regensburgei belongs to the Enterobacteriaceae and shares some biochemical characteristics with Hafnia alvei. A few case reports have suggested that it is an opportunistic pathogen, but there is no strong evidence to support its clinical importance. Until recently, it was difficult to accurately differentiate between Y. regensburgei and H. alvei by use of routine identification techniques. Here, we present a case of soft tissue infection and bacteremia caused by Y. regensburgei, which was successfully treated by intravenous administration of ceftriaxone for three weeks, and review the previous literature. Content Type Journal ArticlePages 1-4DOI 10.1007/s15010-011-0139-zAuthors Y.-C. Lo, Division of Nephrology, Department of Internal Medicine, Taichu...

CEFTRIAXONE SODIUMinjection, Powder, For Solution [Sandoz Inc]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Mon, 20 Jun 2011 05:00:00 +0100

Updated Date: Jun 20, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Unusual Cause of Cellulitis in a Patient with Hepatitis C and Cirrhosis

The American Journal of Medicine — Sat, 18 Jun 2011 19:07:12 +0100

We present an unusual cause of cellulitis in a patient with hepatitis C and cirrhosis. A 61-year-old white woman presented with 4 days of erythema over her mons pubis and labia majora. Her medical history was notable for Child-Pugh C cirrhosis from hepatitis C. On physical examination, her vital signs were normal. She had suprapubic erythema, induration, and allodynia over the mons pubis. White blood cell count was 17,600 with 70% neutrophils. Computed tomographic scan of the pelvis showed swelling of the mons pubis without fluid collections. The patient was treated with vancomycin and ceftriaxone without objective improvement. Culture from the area of cellulitis obtained during incision and drainage grew Cryptococcus neoformans (, A). (Source: The American Journal of Medicine)

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Calcinosis cutis: Part II. Treatment options

Journal of the American Academy of Dermatology — Sat, 18 Jun 2011 16:31:36 +0100

Because calcinosis cutis is a rare syndrome, there is a notable lack of controlled clinical trials on its treatment. The efficacy of calcinosis treatment has only been reported in single cases or small case series. No treatment has been generally accepted as standard therapy, although various treatments have been reported to be beneficial, including warfarin, bisphosphonates, minocycline, ceftriaxone, diltiazem, aluminium hydroxide, probenecid, intralesional corticosteroids, intravenous immunoglobulin, curettage, surgical excision, carbon dioxide laser, and extracorporeal shock wave lithotripsy. (Source: Journal of the American Academy of Dermatology)

Miscellaneous Stone Types

Clinical Reviews in Bone and Mineral Metabolism — Fri, 17 Jun 2011 10:55:03 +0100

Abstract Drug-induced calculi and other rare stone types, such as ammonium acid urate or protein matrix stones, represent only about 2% of all renal calculi. However, the chance to easily reverse stone formation risk by discontinuing the offending drug makes identification of these entities important for clinicians. Additionally, study of these rare stone types contributes to understanding the biochemistry of stone formation. Drug-induced calculi may be classified into two groups based on the mechanism of stone formation. The first group includes drugs that provoke calculi composed of principally the drug and its metabolites. These medications tend to be poorly soluble, highly excreted in urine, and required at high dosages for long durations of therapy. Historically, sulf...

CEFTRIAXONE SODIUMinjection, Powder, For Solution [Hospira, Inc]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Thu, 16 Jun 2011 05:00:00 +0100

Updated Date: Jun 16, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

CEFTRIAXONE SODIUMinjection, Powder, For Solution [Sandoz Inc]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Thu, 16 Jun 2011 05:00:00 +0100

Updated Date: Jun 16, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

MedWorm Sponsor Message: Find the best January Sales in the UK.

CEFTRIAXONE SODIUMinjection, Powder, For Solution [Hospira, Inc]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Thu, 16 Jun 2011 05:00:00 +0100

Updated Date: Jun 16, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Infective endocarditis in a child caused by Cardiobacterium hominis after right ventricular outflow tract reconstruction using an expanded tetrafluoroethylene conduit

General Thoracic and Cardiovascular Surgery — Wed, 15 Jun 2011 05:55:50 +0100

We report a case of infective endocarditis caused by C. hominis in a male child who had undergone right ventricular outflow tract (RVOT) reconstruction using an expanded polytetrafluoroethylene conduit for tetralogy of Fallot with pulmonary atresia. Two days before admission, the patient suffered from exertional shortness of breath. Right ventricular hypertension was confirmed and RVOT stenosis was suspected based on the echocardiography findings. A CT scan revealed vegetation above the cusp of the conduit. An emergency operation was performed to avoid a pulmonary embolism due to large friable vegetation. C. hominis was cultured from the blood and the vegetation, prompting a diagnosis of prosthetic valve endocarditis. The patient was discharged after a 6-week course of intravenous ce...

CEFTRIAXONE SODIUMinjection, Powder, For Solution [Rebel Distributors Corp]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Wed, 15 Jun 2011 05:00:00 +0100

Updated Date: Jun 15, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Antimicrobial susceptibility/resistance and molecular epidemiological characteristics of Neisseria gonorrhoeae in 2009 in Belarus

APMIS — Tue, 14 Jun 2011 23:00:00 +0100

Glazkova S, Golparian D, Titov L, Pankratova N, Suhabokava N, Shimanskaya I, Domeika M, Unemo M. Antimicrobial susceptibility/resistance and molecular epidemiological characteristics of Neisseria gonorrhoeae in 2009 in Belarus. APMIS 2011.Increased antimicrobial resistance (AMR) in Neisseria gonorrhoeae is a global concern, and ultimately gonorrhoea may become untreatable. Nonetheless, AMR data from East‐Europe are scarce beyond Russia, and no AMR data or other characteristics of gonococci have been reported from Belarus for more than 20 years. The aim was to describe the prevalence of AMR, and report molecular epidemiological characteristics of gonococci circulating in 2009 in Belarus. In a sample of 80 isolates, resistance prevalences to antimicrobials used for gonorrhoea treatment i...

Ceftriaxone: Urolithiasis in a child: case report

Reactions — Mon, 13 Jun 2011 16:21:55 +0100

(Source: Reactions)

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Occupational contact allergy to cephalosporins.

Dermatol Online J — Mon, 13 Jun 2011 05:45:04 +0100

Authors: Antunes J, Silva R, Pacheco D, Travassos R, Filipe P Contact sensitivity to systemically administered drugs occurs mainly among healthcare workers and is frequently caused by antibiotics. A 32-year-old nurse presented with a 1½ year history of hand dermatitis and a 2 month history of palpebral eczema, which were clearly work related. Patch tests with standard and gloves series were negative. Testing of the products commonly handled by the patient were positive for cefradine and cefazolin. Testing of other cephalosporins the patient had not come in contact with were also positive for cefuroxime, ceftriaxone, and cefotaxime. This cross-reactivity may be explained by similar molecular structures. The patient stopped preparing cephalosporin solutions for systemic administration a...

Consensus review of the epidemiology and appropriate antimicrobial therapy of complicated urinary tract infections in Asia-Pacific region

Journal of Infection — Sun, 12 Jun 2011 23:00:00 +0100

Summary: Urinary tract infections (UTIs) are among the most prevalent infectious diseases in the general population. They cause a substantial financial burden in the community and are associated with significant morbidity and mortality, particularly in hospitals. With increased rates of antimicrobial resistance, especially in the Asia-Pacific region, treatment of complicated UTIs (cUTIs) can be challenging for clinicians. Consideration of an optimal antimicrobial agent should be based on local resistance patterns, patient-specific factors, pharmacokinetic and pharmacodynamic principles, and cost. In the Asia-Pacific region, nearly half of Escherichia coli urinary isolates were resistant (including intermediate and resistant) to levofloxacin or ciprofloxacin and ≥30% were resistant to thi...

Inpatient management of severe malnutrition: time for a change in protocol and practice.

Annals of Tropical Paediatrics — Fri, 10 Jun 2011 00:15:03 +0100

Authors: Brewster DR This review focuses on how to reduce the high mortality of severe acute malnutrition (SAM) in African hospitals. The World Health Organization's 1999 manual for physicians (protocol) has not resulted in case-fatality rates of under 5%, even in published research studies from Africa, far less in district and central hospitals which do not record case-fatality rates. It is suggested that the following eight changes to the protocol need to be considered if we are serious about reducing case-fatality rates in African hospitals: (1) use of low lactose, low osmolality milk feeds during the early stage of treatment, especially for HIV-exposed infants and diarrhoeal cases; (2) more cautious use of high carbohydrate loads (ORS, ReSoMal, sucrose and 10% dextrose) during init...

GLT-1 overexpression attenuates bladder nociception and local/cross-organ sensitization of bladder nociception

AJP: Renal Physiology — Sun, 05 Jun 2011 23:00:00 +0100

Glutamatergic pathways mediate transmission of pain. Strategies to reduce glutamatergic neurotransmission may have beneficial effects to mitigate nociception. Recent work revealed that overexpression of the astrocytic glutamate transporter (GLT-1) by transgenic or pharmacologic approaches produced a diminished visceral nociceptive response to colonic distension. The purpose of this study was to determine the effect of GLT-1 overexpression on the visceromotor response to bladder distension. Increased glutamate uptake activity produced by 1-wk ceftriaxone (CTX) treatment attenuated 60–64% the visceromotor response to graded bladder distension compared with vehicle-treated mice. One-hour pretreatment with selective GLT-1 antagonist dihydrokainate reversed the blunted visceromotor respon...