No abstract available.
Granulomatous Disease, Chronic* ; Trimethoprim-Sulfamethoxazole Combination

A 32-year-old man presented with epigastric pain. He had a previous episode of acute pancreatitis of undetermined cause 2 years earlier. The patient had taken trimethoprim (80 mg) and sulfamethoxazole (400 mg) twice daily because of acute urethritis 3 days prior to admission. No definite cause of acute pancreatitis could be identified on baseline studies. A thorough history-taking revealed that the patient had an episode of acute pancreatitis while taking trimethoprim (80 mg) and sulfamethoxazole (400 mg) twice daily for 2 weeks for prostatitis prior to the previous admission. Therefore, a cause-and-effect relationship between trimethoprim-sulfamethoxazole (TMP-SMX) and repeated episodes of pancreatitis was highly suggested. The patient was presumably diagnosed as TMP-SMX-induced pancreatitis. The final diagnosis was TMP-SMX-induced pancreatitis. Since drugs are rare causes of acute pancreatitis and the diagnosis of drug-induced pancreatitis is difficult to establish, we report this interesting case along with a review of medical literature.
Adult ; Humans ; Pancreatitis ; Prostatitis ; Sulfamethoxazole ; Trimethoprim ; Urethritis ; Trimethoprim, Sulfamethoxazole Drug Combination

In spite of highly developed antibiotics and chemotherapeutics, genitourinary tract infection still remains as troublesome subjects for urologists. New bactericidal agent, Bactrim (trimethoprim-sulfamethoxazole) was administered in 18 cases of genitourinary tact infection, which were resistant to most antibiotics and following results were obtained. 1) Among 9 cases of non-gonococcal urethritis. 5 cases were cured completely, 4 cases were improved. 2) Among 7 cases of chronic prostatitis, one case was cured but only mild improvement were noted in remaining 6 cases. 3) 2 cases of pyelonephritis showed improvement in both clinically and bacteriologically.
Anti-Bacterial Agents ; Prostatitis ; Pyelonephritis ; Trimethoprim, Sulfamethoxazole Drug Combination* ; Urethritis

A large outbreak of Shigella sonnei gastrointestinal infections occurred at Cheju Island in Korea from May to August 2000. We selected 54 strains which were isolated from the primary treatment failure cases in the outbreak, and characterized the resistance-determining region of the R-plasmid. The 54 strains showed same antimicrobial resistance patterns; resistance against ampicillin, streptomycin, tetracycline, and trimethoprim-sulfamethoxazole. The resistance to ampicillin, streptomycin, and tetracycline were mediated by a conjugable plasmid of about 80 kb size, but the trimethoprim- sulfamethoxazole resistance was not transferred by this plasmid. The R-determining region of the plasmid was cloned and characterized. The 8,384 bp sequences contained resistance genes in the following order:strA, strB, tetR, tetA, and sul1. Fifty four isolates harbored the same sized plasmid and showed same ribotyping patterns, which suggested the clonal spread of S. sonnei in the outbreak.
Ampicillin ; Clone Cells ; Jeju-do* ; Korea ; Plasmids* ; Ribotyping ; Shigella sonnei* ; Shigella* ; Streptomycin ; Sulfamethoxazole ; Tetracycline ; Treatment Failure ; Trimethoprim, Sulfamethoxazole Drug Combination

A large outbreak of Shigella sonnei gastrointestinal infections occurred at Cheju Island in Korea from May to August 2000. We selected 54 strains which were isolated from the primary treatment failure cases in the outbreak, and characterized the resistance-determining region of the R-plasmid. The 54 strains showed same antimicrobial resistance patterns; resistance against ampicillin, streptomycin, tetracycline, and trimethoprim-sulfamethoxazole. The resistance to ampicillin, streptomycin, and tetracycline were mediated by a conjugable plasmid of about 80 kb size, but the trimethoprim- sulfamethoxazole resistance was not transferred by this plasmid. The R-determining region of the plasmid was cloned and characterized. The 8,384 bp sequences contained resistance genes in the following order:strA, strB, tetR, tetA, and sul1. Fifty four isolates harbored the same sized plasmid and showed same ribotyping patterns, which suggested the clonal spread of S. sonnei in the outbreak.
Ampicillin ; Clone Cells ; Jeju-do* ; Korea ; Plasmids* ; Ribotyping ; Shigella sonnei* ; Shigella* ; Streptomycin ; Sulfamethoxazole ; Tetracycline ; Treatment Failure ; Trimethoprim, Sulfamethoxazole Drug Combination

PURPOSE: To compare the efficacy and safety of a 3-day regimen of extended-release ciprofloxacin (ciprofloxacin ER), 500mg qd, with trimethoprim-sulfamethoxazole (TMP/SMX), 800mg/160mg bid, for the empirical treatment of acute uncomplicated cystitis in Korean women. MATERIALS AND METHODS: A randomized, single-blind treatment trial of 75 women with acute uncomplicated cystitis was conducted. The women were prescribed ciprofloxacin ER, 500mg qd, or TMP/SMX, 800mg/160 mg, bid for 3 days. The patients were assessed in terms of the clinical and microbiological outcome and safety 7 days after treatment. RESULTS: Sixty-five women were eligible for the analyses (32 ciprofloxacin ER and 33 TMP/SMX). The most prevalent causative organism was Escherichia coli (76.9%), followed by Proteus (6.2%) and coagulase-negative Staphylococcus (6.2%). The rates of in vitro susceptibility to ciprofloxacin and TMP/SMX were 86.2 (56/65) and 73.4% (48/65), respectively. The clinical cure rates with ciprofloxacin ER and TMP/SMX were 87.5 and 78.8%, respectively. Microbiological cures at 7 days were observed in 25 of the 32 (78.1%) with ciprofloxacin ER and 18 of the 33 (54.5%) with TMP/SMX. The mean interval to improvement in the clinical symptoms after ciprofloxacin and TMP/SMX medications were 1.93+/-0.55 and 2.92+/-0.48 days, respectively. Adverse events with ciprofloxacin and TMP/SMX occurred in 28.1 and 15.5%, respectively, but both treatments were well tolerated. CONCLUSIONS: Although some organisms were resistant (13.8%) to ciprofloxacin, ciprofloxacin ER was superior to TMP/SMX in terms of the clinical and microbiological cure rates and the mean interval to improvement in the clinical symptoms. The high prevalence of resistance and low microbiological cure rates for TMP/SMX suggest that this drug does not provide an adequate initial therapy, while once-daily ciprofloxacin ER was safe and effective in the empirical treatment of symptomatic uncomplicated cystitis.
Ciprofloxacin* ; Cystitis* ; Escherichia coli ; Female ; Humans ; Prevalence ; Proteus ; Staphylococcus ; Trimethoprim-Sulfamethoxazole Combination

Forty-Five cases of Shigellosis were treated with Ampicillin, TMP/SMX and Rifampin from April 1980. to November 1980. Of the 18 strains of shigellae, in-vitro sensitivity test was performed against twelve antimicrobial agents. The percentage of resistant strains was 77.8% in Ampicillin and 100% in TMP/SMX. Inhibition zone diameter by Rifampin disc was 8~10mm in all cases and clinical improvement with treatment was noted in nearly all cases, therefore we regarded inhibition zone diameter above 8mm sensitive to Rifampin. In clinical evaluation, the percentage of effectiveness by antibiotics was as follows; Ampicillin-60%, TMP/SMX-70% and Rifampin-93.3%. Rifampin appears to be the best, available drug bacteriologically and clinically for the treatment of Shilgellosis.
Ampicillin* ; Anti-Bacterial Agents ; Anti-Infective Agents ; Dysentery, Bacillary* ; Humans ; Rifampin* ; Shigella ; Trimethoprim, Sulfamethoxazole Drug Combination*

Nocardia brain abscess is rare. We report on a unique case of N. farcinica brain abscess in a liver transplant recipient, following Aspergillus fumigatus pneumonia. A 43-year-old liver transplant recipient presented with altered mentality at 2 months after A. fumigates pneumonia. He was successfully treated with surgical removal and antibiotic therapy with trimethoprim-sulfamethoxazole and ceftriaxone.
Adult ; Aspergillus fumigatus ; Brain ; Brain Abscess ; Ceftriaxone ; Humans ; Liver ; Nocardia ; Pneumonia ; Transplants ; Trimethoprim, Sulfamethoxazole Drug Combination

Chryseobacterium indologenes (C. indologenes) is a nonmotile, gram-negative bacillus that is widely distributed in nature. Generally considered nonpathogenic, C. indologenes rarely infects humans and is not normally present in the human microflora. C. indologenes infections have been observed in cases of peritoneal dialysis (PD)-associated peritonitis, although the incidence of these infections is low. Although C. indologenes is generally susceptible to trimethoprim-sulfamethoxazole, levofloxacin, ciprofloxacin, piperacillin-tazobactam, and cefepime, no guidelines have been established for the treatment of PD-associated peritonitis. Here we report the first case of PD-associated peritonitis in Korea with C. indologenes identified as the sole etiologic agent. The patient recovered after intraperitoneal antibiotic treatment without the need for Tenckhoff catheter removal.
Bacillus ; Catheters ; Chryseobacterium ; Ciprofloxacin ; Humans ; Incidence ; Korea ; Levofloxacin ; Peritoneal Dialysis ; Peritonitis ; Trimethoprim, Sulfamethoxazole Drug Combination

OBJECTIVES: To determine the occurrence and antimicrobial resistance of pathogenic vibrios from green mussel, Perna viridis in bacoor bay cavite.

METHODS: Vibrios were isolated using TCBS agar and confirmed using API Identification kit. The relationship between the density of vibrios and environment parameters such as months, harvest sites and other physico-chemical parameters of water was determined. The isolated vibrios were subjected to antibiotic resistance testing to determine the resistance patterns.

RESULTS: Pathogenic vibrios were isolated in all of the 90 mussel samples. Of the 183 vibrio isolates, 75 strains were V. alginolyticus and 53 strains belonged to V. cholerae wherein 18 (34%) of these were V. cholerae serotype O1. Forty nine (49) strains belonged to V. parahaemolyticus and six were V. vulnificus. Using the regression analysis, salinity, water temperature and ph have significant correlation on the density of vibrios (p=0.0309), with regression model, total vibrios = -16990763 + 145858 Salinity + 186808 Temperature + 1037886 pH. In the antimicrobial resistance assay,ampicillin had the highest drug resistance (37.8%) followed by nalidixic acid (10.4%), tetracycline (10.4%) and co-trimoxazole (9.3%).

CONCLUSION: Pathogenic vibrios were isolated in mussel of Bacoor, Cavite and can be predicted using salinity, temperature and pH of the water. Thirty six percent (36%) of Vibrio isolates were resistance to ampicillin.