No abstract available.
Cephalosporins*

No abstract available.
Cephalosporins* ; Pneumonia* ; Salicylates*

Cefepime is a fourth-generation cephalosporin that is active against both gram-positive and gram-negative organisms. It is administered parenterally for the treatment of severe infections. Approximately 85% of the drug is excreted unchanged by the kidneys. Neurotoxicity in patients with renal failure who are treated with cefepime has been reported sporadically. We report on two senile patients with renal impairment who developed neurotoxicity including lethal outcome after treatment with cefepime.
Cephalosporins ; Humans ; Kidney ; Renal Insufficiency

Background/Objective: Haemophilus influenzae type b remains to be a significant etiology of invasive infections specially in children two months to five years old without Hib vaccination. This study was performed to compare the cure rates of ampicillin, chloramphenicol, ampicillin-chloramphenicol combination and third generation cephalosporins as initial antibiotic treatments for documented invasive Hib infections. This study may assist in formulating recommendations on empiric antimicrobial therapy. Methods: Charts of patients with invasive Hib disease confirmed either by blood culture, CSF culture and/or latex agglutination test from January 1991 to August 2010 were reviewed. Cases were classified into four groups depending on the initial antibiotic given upon admission. The four groups were compared and analyzed in terms of cure rates. Results The disease occurred predominantly in children less than two years old. Males were more frequently affected than females. All subjects were not given Hib vaccination. Cure rates were significantly different between ampicillin (33%) and chloramphenicol (89%) groups (p=0.017), and between chloramphenicol (89%) and ampicillin-chloramphenicol (39%) groups (p=0.008). However, cure rates were not significantly different when third generation cephalosporin group (62%) was compared to the other treatment groups (p>0.05). Resistance of Hib was 31% to ampicillin, while <10% to chloramphenicol and third generation cephalosporins. Conclusion: Chloramphenicol is an excellent drug for empiric therapy in highly suspected or proven cases of invasive Hib disease.
Ampicillin ; Chloramphenicol ; Third Generation Cephalosporins ; Haemophilus influenzae

BACKGROUND: Introduction of automation instruments for the blood bank is essential in order to reduce inspection error and minimize workload. We compared the results of ABO-RhD blood type and antibody screening tests using the manual method and those using the automation instruments AutoVue Innova (Ortho-Clinical Diagnostics, Raritan, NJ, USA) and QWALYS-3 (DIAGAST, Loos Cedex, France). METHODS: ABO-RhD blood type tests using the slide method, the tube method, and the instruments were performed with 200 selected samples. Antibody screening tests using the Ortho BioVue system (Ortho-Clinical Diagnostics, Raritan, NJ, USA), which is used in our laboratory, and the two instruments were performed with 188 specimens and 12 antibody positive samples that were kept in the laboratory. We evaluated the concordance rate of the results, applying CLSI guideline EP12-A2. RESULTS: The concordance rate of ABO-RhD blood type results between the manual methods and the two instruments was 100%. On antibody screening tests, a concordance rate of 100% was observed between the manual method and AutoVue Innova, which uses the gel card manufactured by the company making the gel card used for the manual method. However, using QWALYS-3 in performance of antibody screening tests, the concordance rate was 97.5%, because of discordance in five specimens. CONCLUSION: The concordance rate of ABO-RhD blood type by use of two automation instruments was 100%, however, that of the antibody screening test was 97.5%. Thus, there was a difference in positive rate on the antibody screening test, depending on the instrument. Therefore, introduction of an instrument, considering the pros and cons for each instrument, is necessary. In addition, further discussion of standardized guidelines for quality control is needed.
Automation ; Blood Banks ; Cephalosporins ; Mass Screening ; Quality Control

Cefepime is a widely used beta-lactam antibiotic. We first report two cases of cefepime-induced reversible encephalpathy in Korea. Two patients with renal impairment presented stupor while being treated with cefepime for pneumonia, one of whom also developed myoclonus and asterixis. Their electroencephalogram showed triphasic waves despite of normal liver function. After discontinuation of cefepime, they completely recovered with normalization of electroencephalogram. Early recognition of cefepime-induced encephalopathy and immediate withdrawal of cefepime would be important for the prognosis of the patients.
Cephalosporins ; Dyskinesias ; Electroencephalography ; Humans ; Korea ; Liver ; Myoclonus ; Pneumonia ; Prognosis ; Stupor

A dynamic multiway principle component analysis for on-line batch process monitoring and fault detection was proposed. It integrates the time-lagged windows of process dynamic behavior with the multiway principle component analysis (MPCA). Using multi-model instead of single model, the dynamic MPCA approach emphasizes particularly on-line process performance monitoring and fault defecting. On-line process monitoring of cephalosporin C fermentation was studied, the results demonstrate that the dynamic MPCA method is able to efficiently monitor performance of the fermentation process and exactly detect faults which results in extraordinary behavior of processes.
Cephalosporins ; biosynthesis ; Fermentation ; Forecasting ; Nonlinear Dynamics ; Principal Component Analysis ; methods

Clostridium tertium-induced bacteremia is a rare condition seen predominantly in neutropenic patients and/or patients with gastrointestinal disease. In this report, we describe a non-neutropenic, 72-year-old patient with a small bowel obstruction who presented with C. tertium bacteremia. Clostridium tertium is aerotolerant and resistant to broad-spectrum cephalosporins. The aerotolerant nature of C. tertium is resulted in delayed identification and reporting since it is not initially considered a candidate for infection.
Aged ; Bacteremia ; Cephalosporins ; Clostridium ; Clostridium tertium ; Gastrointestinal Diseases ; Humans

Penicillins and cephalosporins are commonly prescribed beta-lactam antibiotics that are able to induce severe and sometimes even life-threatening hypersensitivity reactions. These reactions can be broadly classified as immediate or non-immediate/delayed depending on the onset of the reaction after the last drug administration. A definitive diagnosis of beta-lactam hypersensitivity is required to carry out the proper preventive measures. The diagnostic approach to beta-lactam allergy should be considered if the risk/possible benefit ratio is positive. In Korea, however, the diagnostic approach to beta-lactam allergy remains a major challenge. Major and minor determinants of penicillin for skin testing are unavailable, making skin testing appear to be less sensitive. Drug allergy work-ups that include standardized skin tests, reliable in vitro tests, and drug provocation tests are rarely carried out in clinical practice. However, screening patients without a prior history of beta-lactam allergy is routinely recommended. In this review, we discuss practical evaluation of beta-lactam allergy and cross-reactivity between penicillins and cephalosporins.
Anti-Bacterial Agents ; Cephalosporins ; Diagnosis ; Drug Hypersensitivity ; Humans ; Hypersensitivity* ; Korea ; Mass Screening ; Penicillins ; Skin Tests

The basophil activation test (BAT) has been suggested as a complementary method for diagnosing drug allergies. The aim of this study was to evaluate the clinical utility of this test in patients with drug-induced anaphylaxis. In total, 19 patients, all of whom had a history of moderate to severe anaphylaxis, were enrolled. None of the causative drugs had available in vitro tests or reliable skin tests; these drugs included, among others, first and second-generation cephalosporins, H2 blockers, and muscle relaxants. The BAT yielded positive results in 57.9% of the cases, which was similar those results of skin prick and intradermal tests (42.1% and 57.9%, respectively). When basophils were double labelled with CD63 and CD203c, both of which are basophil activation markers, the positive rate was increased from 57.9% to 73.7%. Therefore, the results of this study confirm that the BAT is a quick, reliable, and safe diagnostic tool for patients with drug-induced anaphylaxis.
Anaphylaxis* ; Basophils* ; Cephalosporins ; Drug Hypersensitivity ; Humans ; In Vitro Techniques ; Intradermal Tests ; Methods ; Skin ; Skin Tests