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

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

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

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

Antimicrobial resistance in the hospital is the most important challenging issue in the field of nosocomial infection control. Several nationwide surveys performed so far revealed that various profiles of resistance were already stablished in Korea: the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) was more than 70%; vancomycin-resistant Enterococcus was around 15%; resistance to third generation cephalosporins and aminoglycosides were around 30%, and so on. Although there remains some controversy, association between the development of antimicrobial resistance and the adverse clinical outcome does exist as supported by many studies worldwide. Therefore, combating and overcoming the antimicrobial resistance in the hospital is the most urgent task to solve. For the purpose of eradicating the antimicrobial resistance, we should use a two-edged sword: antimicrobial stewardship and hospital infection control. Regulation of antimicrobials could prevent the emergence of resistance, While infection control and precaution could contain the further spread of resistant organisms. In addition to these, futher aggressive strategy could be used for some species, e.g., active surveillance and \lquote search and destroy\rquote decolonization for MRSA. In conclusion, continuous education of appropriate antimicrobial prescription, implementation of proper precautions, and systematic approach to the infection control via organization of specialized personnel are sine qua non in overcoming the antimicrobial resistance in the hospital.
Aminoglycosides ; Cephalosporins ; Cross Infection ; Education ; Enterococcus ; Infection Control ; Korea ; Methicillin-Resistant Staphylococcus aureus ; Prescriptions ; Prevalence

OBJECTIVES: Cefditoren pivoxil (CDT) has been used in the treatment of rhinosinusitis. However, little is known about the efficacy of this drug at low and high doses. This study was to compare the efficacy and safety of low dose (8-12 mg/kg/day) and high dose (16-20 mg/kg/day) CDT in the treatment of children with uncomplicated acute rhinosinusitis (ARS). METHODS: This investigation was a randomized, investigator-blinded, and parallel study, conducted in patients (aged 1-15 years) with a clinical diagnosis of uncomplicated ARS. Two groups of patients randomly received low dose or high dose CDT for 14 days. Patients' symptoms were assessed quantitatively using a quantitative symptom score (the S5 score). The changes in sinus symptoms and adverse events were provided by patients and their parents/caregivers. The response rate and adverse effects were evaluated at days 7 and 14. The relapse rate was recorded at days 21 and 28. The recurrences of sinus symptoms at day 60 were also assessed. RESULTS: One hundred forty patients were recruited and randomized; 72 received low dose CDT (group I) and 68 received high dose CDT (group II). There were no significant differences in demographic data including sex, age, presenting symptoms, medical history, and X-ray findings between two groups. The responses rate at day 14 in groups I and II were 95.5% and 95.4%, respectively (P>0.99). There were no significant differences between groups in relapse rate at day 28 and no recurrence at day 60 in either group. The most common treatment-related adverse events were diarrhea (4.2% in group I vs. 2.9% in group II) and vomiting (2.8% in group I vs. 10.3% in group II). There was no statistically significant difference in adverse events between groups. CONCLUSION: Both low and high doses regimens of CDT appeared a similar clinical outcome for treatment in uncomplicated ARS in pediatric patients.
Cephalosporins ; Child* ; Diagnosis ; Diarrhea ; Humans ; Prospective Studies* ; Recurrence ; Sinusitis ; Treatment Outcome ; Vomiting