Quinolones
4-Quinolones
Anti-Infective Agents
Ofloxacin
Microbial Sensitivity Tests
Norfloxacin
Topoisomerase II Inhibitors
DNA Gyrase
A bacterial DNA topoisomerase II that catalyzes ATP-dependent breakage of both strands of DNA, passage of the unbroken strands through the breaks, and rejoining of the broken strands. Gyrase binds to DNA as a heterotetramer consisting of two A and two B subunits. In the presence of ATP, gyrase is able to convert the relaxed circular DNA duplex into a superhelix. In the absence of ATP, supercoiled DNA is relaxed by DNA gyrase.
DNA Topoisomerase IV
A bacterial DNA topoisomerase II that catalyzes ATP-dependent breakage of both strands of DNA, passage of the unbroken strands through the breaks, and rejoining of the broken strands. Topoisomerase IV binds to DNA as a heterotetramer consisting 2 parC and 2 parE subunits. Topoisomerase IV is a decatenating enzyme that resolves interlinked daughter chromosomes following DNA replication.
Enoxacin
Nalidixic Acid
Drug Resistance, Microbial
DNA Topoisomerases, Type II
Pefloxacin
Drug Resistance, Bacterial
Fleroxacin
DNA, Superhelical
Oxolinic Acid
Escherichia coli
A species of gram-negative, facultatively anaerobic, rod-shaped bacteria (GRAM-NEGATIVE FACULTATIVELY ANAEROBIC RODS) commonly found in the lower part of the intestine of warm-blooded animals. It is usually nonpathogenic, but some strains are known to produce DIARRHEA and pyogenic infections. Pathogenic strains (virotypes) are classified by their specific pathogenic mechanisms such as toxins (ENTEROTOXIGENIC ESCHERICHIA COLI), etc.
Staphylococcus aureus
Dermatitis, Phototoxic
Streptococcus pneumoniae
Drug Resistance, Multiple, Bacterial
Macrolides
Gram-Negative Bacteria
Bacteria
One of the three domains of life (the others being Eukarya and ARCHAEA), also called Eubacteria. They are unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. Bacteria can be classified by their response to OXYGEN: aerobic, anaerobic, or facultatively anaerobic; by the mode by which they obtain their energy: chemotrophy (via chemical reaction) or PHOTOTROPHY (via light reaction); for chemotrophs by their source of chemical energy: CHEMOLITHOTROPHY (from inorganic compounds) or chemoorganotrophy (from organic compounds); and by their source for CARBON; NITROGEN; etc.; HETEROTROPHY (from organic sources) or AUTOTROPHY (from CARBON DIOXIDE). They can also be classified by whether or not they stain (based on the structure of their CELL WALLS) with CRYSTAL VIOLET dye: gram-negative or gram-positive.
Novobiocin
Pseudomonas aeruginosa
Mutation
Bartonella bacilliformis
Evodia
Mycobacterium fortuitum
Structure-Activity Relationship
Drug Resistance, Multiple
Tetracyclines
Ornidazole
Aminoglycosides
Cephalosporins
Neisseria gonorrhoeae
Gram-Negative Bacterial Infections
beta-Lactams
Four-membered cyclic AMIDES, best known for the PENICILLINS based on a bicyclo-thiazolidine, as well as the CEPHALOSPORINS based on a bicyclo-thiazine, and including monocyclic MONOBACTAMS. The BETA-LACTAMASES hydrolyze the beta lactam ring, accounting for BETA-LACTAM RESISTANCE of infective bacteria.
Trimethoprim-Sulfamethoxazole Combination
Quinazolinones
Plasmids
Chloramphenicol
An antibiotic first isolated from cultures of Streptomyces venequelae in 1947 but now produced synthetically. It has a relatively simple structure and was the first broad-spectrum antibiotic to be discovered. It acts by interfering with bacterial protein synthesis and is mainly bacteriostatic. (From Martindale, The Extra Pharmacopoeia, 29th ed, p106)
Bronchitis, Chronic
Lactams
Bacteroides fragilis
Enterobacteriaceae
A family of gram-negative, facultatively anaerobic, rod-shaped bacteria that do not form endospores. Its organisms are distributed worldwide with some being saprophytes and others being plant and animal parasites. Many species are of considerable economic importance due to their pathogenic effects on agriculture and livestock.
SOS Response (Genetics)
An error-prone mechanism or set of functions for repairing damaged microbial DNA. SOS functions (a concept reputedly derived from the SOS of the international distress signal) are involved in DNA repair and mutagenesis, in cell division inhibition, in recovery of normal physiological conditions after DNA repair, and possibly in cell death when DNA damage is extensive.
Mycobacterium avium Complex
A complex that includes several strains of M. avium. M. intracellulare is not easily distinguished from M. avium and therefore is included in the complex. These organisms are most frequently found in pulmonary secretions from persons with a tuberculous-like mycobacteriosis. Strains of this complex have also been associated with childhood lymphadenitis and AIDS; M. avium alone causes tuberculosis in a variety of birds and other animals, including pigs.
Ureaplasma
Imipenem
Semisynthetic thienamycin that has a wide spectrum of antibacterial activity against gram-negative and gram-positive aerobic and anaerobic bacteria, including many multiresistant strains. It is stable to beta-lactamases. Clinical studies have demonstrated high efficacy in the treatment of infections of various body systems. Its effectiveness is enhanced when it is administered in combination with CILASTATIN, a renal dipeptidase inhibitor.
Stenotrophomonas maltophilia
Colony Count, Microbial
Enumeration by direct count of viable, isolated bacterial, archaeal, or fungal CELLS or SPORES capable of growth on solid CULTURE MEDIA. The method is used routinely by environmental microbiologists for quantifying organisms in AIR; FOOD; and WATER; by clinicians for measuring patients' microbial load; and in antimicrobial drug testing.
Klebsiella pneumoniae
Drug Utilization
Bacterial Outer Membrane Proteins
Mycobacterium
Spiro Compounds
Viridans Streptococci
A large heterogeneous group of mostly alpha-hemolytic streptococci. They colonize the respiratory tract at birth and generally have a low degree of pathogenicity. This group of species includes STREPTOCOCCUS MITIS; STREPTOCOCCUS MUTANS; STREPTOCOCCUS ORALIS; STREPTOCOCCUS SANGUIS; STREPTOCOCCUS SOBRINUS; and the STREPTOCOCCUS MILLERI GROUP. The latter are often beta-hemolytic and commonly produce invasive pyogenic infections including brain and abdominal abscesses.
Enterobacter cloacae
Erythromycin
A bacteriostatic antibiotic macrolide produced by Streptomyces erythreus. Erythromycin A is considered its major active component. In sensitive organisms, it inhibits protein synthesis by binding to 50S ribosomal subunits. This binding process inhibits peptidyl transferase activity and interferes with translocation of amino acids during translation and assembly of proteins.
Urinary Tract Infections
Rifampin
A semisynthetic antibiotic produced from Streptomyces mediterranei. It has a broad antibacterial spectrum, including activity against several forms of Mycobacterium. In susceptible organisms it inhibits DNA-dependent RNA polymerase activity by forming a stable complex with the enzyme. It thus suppresses the initiation of RNA synthesis. Rifampin is bactericidal, and acts on both intracellular and extracellular organisms. (From Gilman et al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 9th ed, p1160)
beta-Lactamases
Salmonella paratyphi A
Citrobacter
Cilastatin
A renal dehydropeptidase-I and leukotriene D4 dipeptidase inhibitor. Since the antibiotic, IMIPENEM, is hydrolyzed by dehydropeptidase-I, which resides in the brush border of the renal tubule, cilastatin is administered with imipenem to increase its effectiveness. The drug also inhibits the metabolism of leukotriene D4 to leukotriene E4.
In vitro activities of cephalosporins and quinolones against Escherichia coli strains isolated from diarrheic dairy calves. (1/269)
The in vitro activities of several cephalosporins and quinolones against 195 strains of Escherichia coli isolated from diary calves affected by neonatal diarrhea were determined. One hundred thirty-seven of these strains produced one or more potential virulence factors (F5, F41, F17, cytotoxic necrotizing factor, verotoxin, and the eae gene), but the remaining 58 strains did not produce any of these factors. From 11 to 18% of the E. coli strains were resistant to cephalothin, nalidixic acid, enoxacin, and enrofloxacin. However, cefuroxime, cefotaxime, and cefquinome were highly effective against the E. coli isolates tested. Some significant differences (P < 0.05) in resistance to quinolones between the strains producing potential virulence factors and nonfimbriated, nontoxigenic, eae-negative strains were found. Thus, eae-positive, necrotoxigenic, and verotoxigenic (except for nalidixic acid) E. coli strains were significantly more sensitive to nalidixic acid, enoxacin, and enrofloxacin than nonfimbriated, nontoxigenic, eae-negative strains. Moreover, eae-positive strains were significantly more sensitive to enoxacin and enrofloxacin than F5-positive strains. Thus, the result of this study suggest that the bovine E. coli strains that produce some potential virulence factors are more sensitive to quinolones than those that do not express these factors. (+info)Cloning, expression, and enzymatic characterization of Pseudomonas aeruginosa topoisomerase IV. (2/269)
The topoisomerase IV subunit A gene, parC homolog, has been cloned and sequenced from Pseudomonas aeruginosa PAO1, with cDNA encoding the N-terminal region of Escherichia coli parC used as a probe. The homolog and its upstream gene were presumed to be parC and parE through sequence homology with the parC and parE genes of other organisms. The deduced amino acid sequence of ParC and ParE showed 33 and 32% identity with that of the P. aeruginosa DNA gyrase subunits, GyrA and GyrB, respectively, and 69 and 75% identity with that of E. coli ParC and ParE, respectively. The putative ParC and ParE proteins were overexpressed and separately purified by use of a fusion system with a maltose-binding protein, and their enzymatic properties were examined. The reconstituted enzyme had ATP-dependent decatenation activity, which is the main catalytic activity of bacterial topoisomerase IV, and relaxing activities but had no supercoiling activity. So, the cloned genes were identified as P. aeruginosa topoisomerase IV genes. The inhibitory effects of quinolones on the activities of topoisomerase IV and DNA gyrase were compared. The 50% inhibitory concentrations of quinolones for the decatenation activity of topoisomerase IV were from five to eight times higher than those for the supercoiling activities of P. aeruginosa DNA gyrase. These results confirmed that topoisomerase IV is less sensitive to fluoroquinolones than is DNA gyrase and may be a secondary target of new quinolones in wild-type P. aeruginosa. (+info)Impact of gyrA and parC mutations on quinolone resistance, doubling time, and supercoiling degree of Escherichia coli. (3/269)
Isogenic mutants derived from quinolone-susceptible isolate WT by introducing gyrA (S83L, D87G) and parC (S80I, E84K) mutations associated with quinolone resistance were characterized with respect to quinolone resistance, growth rate, and degree of global supercoiling. The latter was determined by use of a pair of reporter plasmids carrying supercoiling-dependent promoters pgyrA and ptopA, respectively, transcriptionally fused to the reporter gene bla coding for TEM-1 beta-lactamase. The quotient (Qsc) of the beta-lactamase specific activity determined for a mutant carrying either plasmid was taken as a measure of the degree of global supercoiling. These Qsc data were comparable to results obtained from the separation of topoisomers of plasmid pBR322 on chloroquine-containing agarose gels and indicate a reduced degree of negative supercoiling in resistant mutants relative to the parent, WT. The S83L mutation in gyrA had the strongest influence on quinolone resistance while leaving other parameters nearly unaffected. The gyrA double mutation (S83L plus D87G) had an effect on quinolone resistance similar to that of a single mutation. Phenotypic expression of the parC mutation (S80I) was dependent on the presence of at least one gyrA mutation. Expression of high-level fluoroquinolone resistance (ciprofloxacin MIC, > 4 micrograms/ml) required a combination of the gyrA double mutation and one parC mutation (S80I or E84K). Such mutants showed considerable alterations of growth rate, global supercoiling, or both. Introduction of a parC mutation affected neither the doubling time nor the degree of supercoiling, while the presence of the gyrA D87G mutation was associated with a significant reduction in the degree of DNA supercoiling. (+info)Penetration of moxifloxacin into peripheral compartments in humans. (4/269)
To characterize the penetration of moxifloxacin (BAY 12-8039) into peripheral target sites, the present study aimed at measuring unbound moxifloxacin concentrations in the interstitial space fluid by means of microdialysis, an innovative clinical sampling technique. In addition, moxifloxacin concentrations were measured in cantharides-induced skin blisters, saliva, and capillary plasma and compared to total- and free-drug concentrations in venous plasma. For this purpose, 12 healthy volunteers received moxifloxacin in an open randomized crossover fashion either as a single oral dose of 400 mg or as a single intravenous infusion of 400 mg over 60 min. An almost-complete equilibration of the free unbound plasma fraction of moxifloxacin with the interstitial space fluid was observed, with mean area under the concentration-time curve (AUC)(interstitial fluid)/AUC(total-plasma) ratios ranging from 0.38 to 0.55 and mean AUC(interstitial fluid)/AUC(free-plasma) ratios ranging from 0.81 to 0.86. The skin blister concentration/plasma concentration ratio reached values above 1.5 after 24 h, indicating a preferential penetration of moxifloxacin into inflamed lesions. The moxifloxacin concentrations in saliva and capillary blood were similar to the corresponding levels in plasma. Our data show that moxifloxacin concentrations attained in the interstitial space fluid in humans and in skin blister fluid following single doses of 400 mg exceed the values for the MIC at which 90% of isolates are inhibited for most clinically relevant bacterial strains, notably including penicillin-resistant Streptococcus pneumoniae. These findings support the use of moxifloxacin for the treatment of soft tissue and respiratory tract infections in humans. (+info)Pharmacokinetics of antibiotics in burn patients. (5/269)
Drug pharmacokinetics are significantly altered in the burned patient but the interplay of a large number of variables is involved in deciding how an individual will deal with a drug. Consequently the burn patient population shows significant inter- and intrapatient variation. In 1976 altered aminoglycoside pharmacokinetics and the need for increased dosage in burn patients was reported but, despite this early study, a review of the currently available literature shows that for many drugs there is a paucity of information to support current dosage recommendations. In addition, many reports are based upon small numbers of patients, and even in larger studies there is no standardization of the study population with regard to the important variables known to affect drug handling. For the sub-population of burn patients who eliminate drugs extremely rapidly, a concern exists over the adequacy of antibiotic dosing. It is suggested that antibiotic serum concentrations be measured for all drugs in every patient to ascertain whether there is a significant problem with dosing. Additionally, future pharmacokinetic studies need to be standardized in burn patients. (+info)Activity of moxifloxacin against mycobacteria. (6/269)
Moxifloxacin is an 8-methoxyquinolone compound with activity against a wide range of bacteria. We tested its activity in comparison with four other quinolones and isoniazid against clinical isolates of mycobacteria. It proved to be the most active of the quinolones tested against Mycobacterium tuberculosis (MIC90 0.25 mg/L), Mycobacterium avium-intracellulare (MIC90 1.0 mg/L), Mycobacterium kansasii (MIC90 0.06 mg/L) and Mycobacterium fortuitum (MIC90 1 mg/L). These data indicate that moxifloxacin merits further study as an antimycobacterial agent. (+info)Characterization of MexT, the regulator of the MexE-MexF-OprN multidrug efflux system of Pseudomonas aeruginosa. (7/269)
We investigated the regulation of the MexEF-OprN multidrug efflux system of Pseudomonas aeruginosa, which is overexpressed in nfxC-type mutants and confers resistance to quinolones, chloramphenicol and trimethoprim. Sequencing of the DNA region upstream of the mexEF-oprN operon revealed the presence of an open reading frame (ORF) of 304 amino acids encoding a LysR-type transcriptional activator, termed MexT. By using T7-polymerase, a 34-kDa protein was expressed in Escherichia coli from a plasmid carrying the mexT gene. Expression of a mexE::lacZ fusion was 10-fold higher in nfxC-type mutants than in the wild-type strain; however, transcription of mexT as well as the mexT DNA region was unchanged. Located adjacent to mexT but transcribed in opposite direction, the beginning of an ORF termed qrh (quinone oxidoreductase homologue) was identified. Expression of a qrh::lacZ fusion was also found to be activated by MexT. Further, we present evidence for coregulation at the transcriptional and the posttranscriptional level between the MexEF-OprN efflux system and the OprD porin responsible for cross-resistance of nfxC-type mutants to carbapenem antibiotics. (+info)Purification and inhibition by quinolones of DNA gyrases from Mycobacterium avium, Mycobacterium smegmatis and Mycobacterium fortuitum bv. peregrinum. (8/269)
The DNA gyrases from Mycobacterium avium, Mycobacterium smegmatis and Mycobacterium fortuitum bv. peregrinum, which are species naturally resistant, moderately susceptible and susceptible to fluoroquinolones, respectively, were purified by affinity chromatography on novobiocin-Sepharose columns. The DNA gyrase inhibiting activities (IC50 values) of classical quinolones and fluoroquinolones were determined from the purified enzymes and were compared to the corresponding antibacterial activities (MICs). Regarding M. fortuitum bv. peregrinum, which is nearly as susceptible as Escherichia coli, the corresponding MIC and IC50 values of quinolones were significantly lower than those found for M. avium and M. smegmatis (e.g. for ofloxacin, MICs of 0.25 versus 32 and 1 microg ml(-1), and IC50 values of 1 versus 8 and 6 microg ml(-1), respectively). Such a result could be related to the presence of Ser-83 in the quinolone-resistance-determining region of the gyrase A subunit of M. fortuitum bv. peregrinum, as found in wild-type E. coli, instead of Ala-83 in M. avium and M. smegmatis, as found in fluoroquinolone-resistant E. coli mutants. The IC50 values of quinolones against the M. avium and M. smegmatis DNA gyrases were similar, while the corresponding MICs were 32-fold higher for M. avium when compared to M. smegmatis, suggesting that an additional mechanism, such as a low cell wall permeability or a drug efflux, could contribute to the low antibacterial potency of quinolones against M. avium. (+info)
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Cirrhosis: Practice Essentials, Overview, Etiology
... and in hospital settings with high prevalence of quinolone-resistant bacterial infections. Oral quinolones (norfloxacin 400 mg ... Ceftriaxone (1 g/24 hr) is the first choice in patients with decompensated cirrhosis, those already on quinolone prophylaxis, ... Neomycin and other antibiotics (eg, metronidazole, oral vancomycin, paromomycin, oral quinolones) serve as second-line agents. ... 77] The discovery of a liver nodule should prompt the performance of a 4-phase CT scan or an MRI scan (ie, unenhanced, arterial ...
Volume 44, Issue 4 | Microbiology Society
Mechanisms of quinolone action and resistance: where do we stand? Susana Correia, Patrícia Poeta, Michel Hébraud, José Luis ... 1), Citrobacter freundii (1) and Escherichia coli (4), one each of types O1, O18ac and O98 and an untypable strain. Despite the ... Pre-exposure of C. albicans isolates (seven proteinase producers from each group) to 1/4 and 1/16 MICs of nystatin, ... https://doi.org/10.1099/00222615-44-4-261 More Less A PCR procedure for the detection of Bordetella pertussis in nasopharyngeal ...
National Action Plan to Combat Multidrug-Resistant Tuberculosis
... quinolone/pyrazinamide. 2. Initiate in vivo evaluation of quino- CDC 1992 lones. NIH HRSA 3. Evaluate depot preparations for ... Problem 4. LABORATORY DIAGNOSIS. Problem 5. Problem 6. Problem 7. PATIENT MANAGEMENT. Problem 8. Problem 9. Problem 10. Problem ... 4. Publish recommendations and guide- ACET 1993 lines. CDC Problem 15. Homeless TB patients are often not able to complete TB ... CDC 4. Develop an evaluation instrument, ACET 1992-93 based on the criteria for a model TB CDC control program, to be used as a ...
Synthesis and binding studies of a 1-alkyl-3,6-diamino-4-quinolone based receptor for N-acylated dipeptides - Fingerprint ...
Synthesis of Hybrid Fluoroquinolone-Boron Complexes and Their Evaluation in Cervical Cancer Cell Lines
... as quinolone-metal complex. In this work, the use of boron is shown as an alternative of metal to form a complex by ... Quinolones are a family of antimicrobial agents that have been used in antibacterial and anticancer chemotherapy. ... Several quinolones modifications have been shown to improve properties in cancer treatment. Some modifications comprise ß-keto ... Metal quinolone chelates play an important role in drug bioavailability, and decreased absorption is produced when it is ...
Fosrenol (lanthanum carbonate) dosing, indications, interactions, adverse effects, and more
Administer oral quinolone antibiotics at least 1 hr before or 4 hr after lanthanum. Interaction applies only to oral quinolones ... Administer oral quinolone antibiotics at least 1 hr before or 4 hr after lanthanum. Interaction applies only to oral quinolones ... Administer oral quinolone antibiotics at least 1 hr before or 4 hr after lanthanum. Interaction applies only to oral quinolones ... Administer oral quinolone antibiotics at least 1 hr before or 4 hr after lanthanum. Interaction applies only to oral quinolones ...
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In vitro activity of quinolones against S. pneumoniae, H. influenzae and M. catarrhalis in Saudi Arabia Balkhy, H.H.; Memish ... AuthorWorld Health Organization (4)Al Ghamdi, Y.S. (1)Al Mazrou, Y.Y. (1)Balkhy, H.H. (1)El Bashier, A. (1)... View ... Streptococcus pneumoniae (4)Drug Resistance, Microbial (3)Developing Countries (2)Handbook (2)... View MoreDate Issued ... Isolates were from patients with invasive disease at 4 hospitals in Saudi Arabia between 1996 and 1998. S. pneumoniae isolates ...
Table 3 - Fluoroquinolone Resistance in Penicillin-resistant Streptococcus pneumoniae Clones, Spain - Volume 10, Number 10...
aQRDR, quinolone-resistance determining regions; PFGE, pulse-field gel electrophoresis SmaI patterns; aa, amino acid; nt, ... 4 μg/mL); C, resistant to chloramphenicol (MIC ,8 μg/mL); E, resistant to erythromycin (MIC ,0.5 μg/mL); Cl, resistant to ... 4 μg/mL). Residue changes involved in fluoroquinolone resistance are showed in boldface, and double underlining indicates that ... nucleotide; S, susceptible to all antibiotics tested; P, resistant to penicillin (MIC 0.12-4 μg/mL); T, resistant to ...
Kuş N
The quinolone-hydroxyquinoline tautomerism in quinolone 3-esters; preserving the 4-oxoquinoline structure to retain ... Recent publications report in vitro activity of quinolone 3-esters against the bc1 protein complex of Plasmodium falciparum and ... Docking studies performed in silico at the yeast Qo site established a key role for the 4-oxo and N-H groups in drug-target ... Thus, the possibility of 4-oxoquinoline/4-hydroxyquinoline tautomerism may impact in pharmacologic profiles and should be ...
Conferences-en
Flow Injection Chemiluminometric Determination of Quinolones. Instrumental Methods of Analysis, Modern Trends and Applications ... 6th International Conference "Instrumental Methods of Analysis, Modern Trends and Applications" (IMA2009), 4-8 October, Athens ... 6th International Conference "Instrumental Methods of Analysis, Modern Trends and Applications" (IMA2009), 4-8 October, Athens ... 6th International Conference "Instrumental Methods of Analysis, Modern Trends and Applications" (IMA2009), 4-8 October, Athens ...
Cirrhosis: Practice Essentials, Overview, Etiology
... and in hospital settings with high prevalence of quinolone-resistant bacterial infections. Oral quinolones (norfloxacin 400 mg ... Ceftriaxone (1 g/24 hr) is the first choice in patients with decompensated cirrhosis, those already on quinolone prophylaxis, ... Neomycin and other antibiotics (eg, metronidazole, oral vancomycin, paromomycin, oral quinolones) serve as second-line agents. ... 77] The discovery of a liver nodule should prompt the performance of a 4-phase CT scan or an MRI scan (ie, unenhanced, arterial ...
Zinc: MedlinePlus Supplements
Antibiotics (Quinolone antibiotics). Zinc might decrease how much antibiotic the body absorbs from the gut. Taking zinc along ... Hepatology 2000;32(4 Pt 1):877. View abstract.. * Munoz, E. C., Rosado, J. L., Lopez, P., Furr, H. C., and Allen, L. H. Iron ... 2012 Jun;26:111-4. View abstract.. *Li P, Xu J, Shi Y, Ye Y, Chen K, Yang J, Wu Y. Association between zinc intake and risk of ... 2012;4:CD006639. View abstract.. * Haider, B. A., Lassi, Z. S., Ahmed, A., and Bhutta, Z. A. Zinc supplementation as an adjunct ...
Ascites, Hospital Medicine - Renal and Urology News
An oral quinolone is generally used.. One study showed a significant reduction in renal failure and mortality (absolute risk ... May use oral quinolone as well, especially if patient is otherwise ready for discharge ... This and another study showed that low-risk patients (bilirubin , 4 mg/dL, BUN , 30 mg/dL, and creatinine , 1 mg/dL) did well ...