The antibacterial activities of nitazoxanide and its main metabolite, tizoxanide, were tested against a broad range of bacteria, including anaerobes. Metronidazole, amoxicillin, amoxicillin-clavulanic acid, piperacillin, cefoxitin,... more
The antibacterial activities of nitazoxanide and its main metabolite, tizoxanide, were tested against a broad range of bacteria, including anaerobes. Metronidazole, amoxicillin, amoxicillin-clavulanic acid, piperacillin, cefoxitin, imipenem, and clindamycin were used as positive controls. MICs were determined by reference agar dilution methods. The 241 anaerobes were all inhibited by nitazoxanide, with the MICs at which 90% of isolates are inhibited (MIC90S) being between 0.06 and 4 mg/liter with the exception of those for Propionibacterium species, for which the MIC90 was 16 mg/liter. The MIC90s of nitazoxanide were 0.5 mg/liter for the Bacteroides fragilis group (80 strains), 0.06 mg/liter for Clostridium difficile (21 strains), and 0.5 mg/liter for Clostridium perfringens (16 strains). Metronidazole showed a level of activity comparable to that of nitazoxanide except against Bifidobacterium species, against which it was poorly active, and Propionibacterium species, which were res...
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Eighteen patients (13 under mechanical ventilation) in an intensive care unit received piperacillin for pneumonia (7 cases) or bronchial infection (11 cases), related to Haemophilus influenzae (7), Streptococcus pneumoniae (4) or... more
Eighteen patients (13 under mechanical ventilation) in an intensive care unit received piperacillin for pneumonia (7 cases) or bronchial infection (11 cases), related to Haemophilus influenzae (7), Streptococcus pneumoniae (4) or miscellaneous pathogens (7) including Staphylococcus, E. coli, Klebsiella pneumoniae and Proteus mirabilis. Each patient was given 2g piperacillin intravenously every six hours. Concentrations in serum and bronchial secretion samples were assayed by the agar diffusion technique using a susceptible strain of Bacillus subtilis ATCC 6633. Maximum concentrations were 157 micrograms/ml in serum and 3.60 micrograms/ml in bronchial secretions. These results are similar to those obtained with the same dosage by 0. Cars in serum (150 micrograms/ml) and by G.E. Marlin in the bronchial secretions (3.78 micrograms/ml). They approximate those published for other penicillins with the same dosage.
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The preliminary results obtained in 212 patients from 20 intensive care units, suffering from pneumonia or nosocomial septicemia and treated at random with either ceftazidime + pefloxacin (CP) or ceftazidime + amikacin (CA) were analyzed.... more
The preliminary results obtained in 212 patients from 20 intensive care units, suffering from pneumonia or nosocomial septicemia and treated at random with either ceftazidime + pefloxacin (CP) or ceftazidime + amikacin (CA) were analyzed. After exclusion of patients who did not comply with the protocol and of cases where no organism was isolated, 57 assessable patients received CP and 72 received CA. The cure rates achieved in infections due to a single organism were 85 per cent in the CA group and 63 per cent in the CP group. In infections due to multiple organisms, the cure rate was 74 +/- 2 per cent with both antibiotic regimens.
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Three hundred fifty-two patients from 20 intensive care units, suffering from pneumonia or nosocomial septicemia were treated at random with either ceftazidime + pefloxacin (CP) or ceftazidime + amikacin (CA). After exclusion of patients... more
Three hundred fifty-two patients from 20 intensive care units, suffering from pneumonia or nosocomial septicemia were treated at random with either ceftazidime + pefloxacin (CP) or ceftazidime + amikacin (CA). After exclusion of patients who did not comply with the protocol and of cases where no organism was isolated, 108 assessable patients received CP and 114 received CA. The cure rates achieved in infections due to a single organism were 82 per cent in the CA group and 62 per cent in the CP group. In infections due to multiple organisms, the cure rate was 67 per cent with both antibiotic regimens.
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For the empiric management of community-acquired pneumonia, ciprofloxacin (750 mg b.i.d.) was compared with two antibiotics frequently used in this indication, i.e., amoxicillin + clavulanic acid and erythromycin. One hundred and... more
For the empiric management of community-acquired pneumonia, ciprofloxacin (750 mg b.i.d.) was compared with two antibiotics frequently used in this indication, i.e., amoxicillin + clavulanic acid and erythromycin. One hundred and forty-two patients were randomized in this prospective study. Among them, the 63 patients with bacteriologically documented disease were evaluated. Clinical recovery was achieved in 73.3% of patients in the ciprofloxacin group (22/30) versus 81.8% of patients in the amoxicillin + clavulanic acid or erythromycin group (27/33) (non-significant difference). Clinical failures seen with ciprofloxacin were found to be correlated with recovery of Streptococcus pneumoniae. Ciprofloxacin is effective in pneumonia but should be used only in cases where Streptococcus pneumoniae can be excluded as the causative agent.
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Research Interests: Pregnancy, Humans, Child, Female, Newborn Infant, and 5 moreAdult, Chickenpox, Encephalitis, Child preschool, and Purpura
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The need for predicting bacteriological and clinical antibiotic activity appeared early after development of the first antibiotics. Antimicrobial efficacy is significant among many therapeutic management factors, including surgery, drug... more
The need for predicting bacteriological and clinical antibiotic activity appeared early after development of the first antibiotics. Antimicrobial efficacy is significant among many therapeutic management factors, including surgery, drug interactions and non-antibiotic therapies. Clinical efficacy is not only related to antimicrobial efficacy, but also to host characteristics and causative organism attributes. Because all these factors interact to achieve success or failure in the management of a given infected patient, to model an n-factor in vivo system from n'-factors in vitro may be difficult.
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Given orally, currently marketed fluoroquinolones, ciprofloxacin, ofloxacin and pefloxacin are absorbed rapidly, have an excellent diffusion coefficient. They are wide-spectrum first intention antibiotics effective against Gram negative... more
Given orally, currently marketed fluoroquinolones, ciprofloxacin, ofloxacin and pefloxacin are absorbed rapidly, have an excellent diffusion coefficient. They are wide-spectrum first intention antibiotics effective against Gram negative bacilli, staphylococci and intracellular germs such as Legionella, Chlamydiae and mycoplasms. The spectrum does however not include streptococci, and in particular pneumococci, and anaerobic germs. The development of resistant strains, particularly in hospital settings, have been observed and despite their fundamental properties, the use of fluoroquinolones has been restrained for infections of the respiratory tract. Actually, the insensitivity of pneumococci or anaerobic germs means that fluoroquinolones cannot be used empirically for isolated cases of pneumonia or sinusitis. They can however be used successfully, either empirically, in a combination regimen or after identification of the bacteria, for treating infections due to Gram negative bacill...
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Pneumococcal infection remains a public health problem, because of its important incidence, as well for pneumonias (2 cases per 1,000 persons per year) as for bacteremias (0.5% among hospitalized patients). The fatality rate in the... more
Pneumococcal infection remains a public health problem, because of its important incidence, as well for pneumonias (2 cases per 1,000 persons per year) as for bacteremias (0.5% among hospitalized patients). The fatality rate in the bacteremic cases is 37.3% and reaches 89% in the fulminant sepsis cases, which are observed especially in splenectomized patients: the spleen takes part in the host defences against Streptococcus pneumoniae, together with the phagocytosis, the antibody production and the complement activation, essentially through the alternative complement pathway-activated C3b. Bacterial opsonization remains the fundamental mechanism of the host defence in the early stages of the pneumococcal infection.
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Twenty-patients (14 with mechanical ventilation) received moxalactam in an intensive care unit for pneumonia (3 cases), empyema (5 cases), bronchopneumonia (8 cases), bronchopneumonia with bacteremia (4 cases), 23 organism were isolated... more
Twenty-patients (14 with mechanical ventilation) received moxalactam in an intensive care unit for pneumonia (3 cases), empyema (5 cases), bronchopneumonia (8 cases), bronchopneumonia with bacteremia (4 cases), 23 organism were isolated and 16 were hospital-acquired: Staphylococcus (3), Escherichia coli (1), Klebsiella-Enterobacter-Serratia (5), Proteus (3), Aeruginosa (2), Acinetobacter (2), These patients received moxalactam at the dosage of 500 mg/8H, 5 at 1 g/12H and 13 at 1 g/8H. Daily dosage ranged between 25 and 50 mg/kg; mode of administration was IM (16) or IV infusion pump (5) and mean duration of treatment was 12 days (range 6-21). Serum and bronchial secretion samples were assayed by the agar diffusion technique utilizing a susceptible strain of enterobacter cloacae (0.06 microgram/ml) as assay organism. At 1 h, mean serum concentrations were 31.5 micrograms/ml after 1 g IM every 12H, 54.9 micrograms/ml after 1 g IM every 8H and at 30 mn after the end of the infusion, se...