Microbial Sensitivity Tests
Structure-function studies of Ser-289 in the class C beta-lactamase from Enterobacter cloacae P99. (1/308)Site-directed mutagenesis of Ser-289 of the class C beta-lactamase from Enterobacter cloacae P99 was performed to investigate the role of this residue in beta-lactam hydrolysis. This amino acid lies near the active site of the enzyme, where it can interact with the C-3 substituent of cephalosporins. Kinetic analysis of six mutant beta-lactamases with five cephalosporins showed that Ser-289 can be substituted by amino acids with nonpolar or polar uncharged side chains without altering the catalytic efficiency of the enzyme. These data suggest that Ser-289 is not essential in the binding or hydrolytic mechanism of AmpC beta-lactamase. However, replacement by Lys or Arg decreased by two- to threefold the kcat of four of the five beta-lactams tested, particularly cefoperazone, cephaloridine, and cephalothin. Three-dimensional models of the mutant beta-lactamases revealed that the length and positive charge of the side chain of Lys and Arg could create an electrostatic linkage to the C-4 carboxylic acid group of the dihydrothiazine ring of the acyl intermediate which could slow the deacylation step or hinder release of the product. (+info)
Pharmacokinetics of intermittent intraperitoneal cefazolin in continuous ambulatory peritoneal dialysis patients. (2/308)OBJECTIVE: To investigate the pharmacokinetic parameters of intermittent intraperitoneal (IP) cefazolin, and recommend a cefazolin dosing regimen in continuous ambulatory peritoneal dialysis (CAPD) patients. DESIGN: Prospective nonrandomized open study. SETTING: CAPD outpatient clinic in Albany, New York. PATIENTS: Seven volunteer CAPD patients without peritonitis. Three of the patients were nonanuric while 4 were anuric. INTERVENTIONS: Cefazolin (15 mg/kg total body weight) was given to each patient during the first peritoneal exchange. Blood and dialysate samples were collected at times 0, 0.5, 1,2,3,6 (end of the first antibiotic-containing dwell), 24, and 48 hours after the administration of IP cefazolin. Urine samples were collected in nonanuric patients over the study period. RESULTS: The mean+/-SD amount of cefazolin dose absorbed from the dialysate after the 6-hour dwell was 69.7%+/-8.0% of the administered dose. The cefazolin absorption rate constant from dialysate to serum was 0.21+/-0.1/hr (absorption half-life 3.5+/-0.8 hr). The mean serum concentrations reached at 24 and 48 hours were 52.4+/-3.7 mg/L and 30.3+/-5.9 mg/L, respectively. The mean dialysate cefazolin concentrations reached at 24 and 48 hours were 15.1+/-3.4 mg/L and 7.9+/-1.4 mg/L, respectively. The cefazolin serum elimination rate constant was 0.02+/-0.01/hr (elimination half-life 31.5+/-8.8 hr). The total cefazolin body clearance was 3.4+/-0.6 ml/min. In the 3 nonanuric patients the mean renal clearance of cefazolin was 0.6+/-0.4 ml/min. The peritoneal clearance of cefazolin was 1.0+/-0.3 mL/min. The systemic volume of distribution of cefazolin was 0.2+/-0.05 L/kg. No statistical difference was detected in pharmacokinetic parameters between anuric and nonanuric patients, although this may be due to the small number of patients in each group. CONCLUSION: A single daily dose of cefazolin dosed at 15 mg/kg actual body weight in CAPD patients is effective in achieving serum concentration levels greater than the minimum inhibitory concentration for sensitive organisms over 48 hours, and dialysate concentration levels over 24 hours. Caution is warranted in extrapolation of dosing recommendations to patients who maintain a significant degree of residual renal function. (+info)
Primary Shewanella alga septicemia in a patient on hemodialysis. (3/308)We report the first Japanese case of primary septicemia with Shewanella alga and also describe the bacteriological characteristics of and results of antibiotic susceptibility tests of the isolate. S. alga was repeatedly isolated, at times simultaneously with Escherichia coli, from the blood of a 64-year-old female undergoing hemodialysis. The isolated organism was determined to be S. alga based on recently published identification criteria, such as hemolysis on sheep blood agar, no acid production from carbohydrates, and growth on agar containing 6. 5% NaCl. Results of antibiotic susceptibility tests demonstrated that the isolate was sensitive to levofloxacin and cefpirome (MICs, 128, 64, and 8 microg/ml, respectively). Although the role of S. alga as a human pathogen has not been fully determined, accumulating data suggest that this organism may be a potential pathogen, especially in compromised hosts. (+info)
Prophylactic cefazolin in amnioinfusions administered for meconium-stained amniotic fluid. (4/308)OBJECTIVE: To determine if amnioinfusion with an antibiotic solution decreased the rate of clinical chorioamnionitis and puerperal endometritis in patients with meconium-stained amniotic fluid. METHODS: Patients in labor at 36 weeks of gestation or greater with singleton pregnancies and meconium-stained amniotic fluid were randomized to receive either cefazolin, 1 g/1,000 mL, of normal saline (n = 90) or normal saline (n = 93) amnioinfusion. Rates of clinically diagnosed chorioamnionitis and endometritis and of suspected and culture-proven neonatal infection were determined. RESULTS: Between the study and control groups, the incidences of clinical chorioamnionitis (7.8% vs. 8.6%), endometritis (2.4% vs. 3.5%), aggregate intrauterine infection (10.0% vs. 11.8%), suspected neonatal infection (17.8% vs. 21.5%), and proven neonatal infection (0.0% vs. 2.2%) were not significantly different. CONCLUSIONS: Prophylactic use of cefazolin in amnioinfusions did not significantly reduce rates of maternal or neonatal infection in patients with meconium-stained amniotic fluid. (+info)
Antibacterial activity of combinations of cefazolin and semisynthetic penicillins. (5/308)The antibacterial activity of cephalosporin (CS) and semisynthetic penicillins was studied using CS-resistant strains of Escherichia freundii and Proteus morganii. A synergistic growth inhibitory action toward these microorganisms was demonstrated by a qualitative method and confirmed by a quantitative determination. (+info)
Treatment of hospitalized patients with complicated gram-positive skin and skin structure infections: two randomized, multicentre studies of quinupristin/dalfopristin versus cefazolin, oxacillin or vancomycin. Synercid Skin and Skin Structure Infection Group. (6/308)Quinupristin/dalfopristin (Synercid), the first injectable streptogramin antibiotic available for the treatment of complicated gram-positive skin and skin structure infections, was compared with standard comparators (cefazolin, oxacillin or vancomycin) in one USA and one international trial. These two randomized, open-label trials of virtually identical design enrolled a total of 893 patients (450 quinupristin/dalfopristin, 443 comparator). The majority of patients had erysipelas, traumatic wound infection or clean surgical wound infection. Staphylococcus aureus was the most frequently isolated pathogen in both treatment groups and polymicrobial infection was more common in the quinupristin/dalfopristin group than in the comparator group. The clinical success rate (cure plus improvement) in the clinically evaluable population was equivalent between the two treatment groups (68.2% quinupristin/dalfopristin, 70.7% comparator; 95% CI, -10.1, 5.1) despite a shorter mean duration of treatment for quinupristin/dalfopristin patients. In the bacteriologically evaluable population, by-patient and by-pathogen bacteriological eradication rates were somewhat lower for quinupristin/dalfopristin (65.8% and 66.6%, respectively) than for the comparator regimens (72.7% and 77.7%, respectively). The lower bacteriological response rates in the quinupristin/dalfopristin group were, in part, due to a higher rate of polymicrobial infections and a higher incidence of patients classified as clinical failure, a category which included premature discontinuation of treatment because of local venous adverse events. The bacteriological eradication rate for quinupristin/dalfopristin was higher in monomicrobial infections than in polymicrobial infections (72.6% versus 63.3%, respectively), whereas the corresponding rate for the comparator regimens was lower for monomicrobial infections than polymicrobial infections (70.8% versus 83.1%). This finding was not unexpected, since the spectrum of quinupristin/dalfopristin is focused on gram-positive pathogens and additional antibiotics to treat gram-negative bacteria were not required per protocol. The systemic tolerability of both treatment regimens was qualitatively similar. A higher rate of drug-related venous adverse events was reported for quinupristin/dalfopristin (66.2%) than for the comparator regimen (28.4%). Premature discontinuation of study drug was primarily due to adverse clinical events for quinupristin/dalfopristin (19.1%), whereas the most common reason for discontinuation among those receiving the comparator regimens was treatment failure (11.5%). Quinupristin/dalfopristin is an effective alternative for the treatment of hospitalized patients with complicated skin and skin structure infections due to quinupristin/ dalfopristin-susceptible gram-positive organisms, including methicillin- and erythromycin-resistant S. aureus. (+info)
Bacteremic pneumonia caused by a single clone of Streptococcus pneumoniae with different optochin susceptibilities. (7/308)Two isolates of Streptococcus pneumoniae having different optochin susceptibilities were recovered from a blood sample of a 2-year-old boy with community-acquired pneumonia. The two isolates were documented to belong to a single clone on the basis of the isolates' identical serotype (23F), antibiograms by the E-test, random amplified polymorphic DNA patterns generated by arbitrarily primed PCR, pulsed-field gel electrophoresis, and restriction fragment length polymorphism of the penicillin-binding protein genes pbp2b and pbp2x. (+info)
Fluoroquinolone and fortified antibiotics for treating bacterial corneal ulcers. (8/308)AIM: To compare the clinical efficacy of commercially available fluoroquinolone drops with the use of combined fortified antibiotics (tobramycin 1.3%-cefazolin 5%) in treatment of bacterial corneal ulcer. METHODS: The medical records of 140 patients with a diagnosis of bacterial corneal ulcer who were admitted to the Royal Victorian Eye and Ear Hospital, Melbourne, Australia between January 1993 and December 1997 were reviewed retrospectively. Final outcome and results of 138 ulcer episodes were compared between those treated initially with fluoroquinolone and those who received fortified antibiotics. Two patients had been treated with chloramphenicol. RESULTS: No significant treatment difference was found between fluoroquinolone and fortified therapy in terms of final visual outcome. However, serious complications such as corneal perforation, evisceration, or enucleation of the affected eye were more common with fluoroquinolone therapy (16.7%) compared with the fortified therapy (2.4%, p= 0.02). The duration of intensive therapy was less with fluoroquinolone especially in those over 60 years of age (4 days v 6 days, p=0.01). Hospital stay was also less in the fluoroquinolone group compared with the fortified group for all patients and was significantly less with fluoroquinolone treatment (7 days v 10 days, p=0.02) in patients in the age group over 60 years old. CONCLUSIONS: Monotherapy with fluoroquinolone eye drops for the treatment of bacterial corneal ulcers led to shorter duration of intensive therapy and shorter hospital stay compared with combined fortified therapy (tobramycin-cefazolin). This finding may have resulted from quicker clinical response of healing as a result of less toxicity found in the patients treated with fluoroquinolone. However, as some serious complications were encountered more commonly in the fluoroquinolone group, caution should be exercised in using fluoroquinolones in large, deep ulcers in the elderly. (+info)
Staphylococcal infections can be classified into two categories:
1. Methicillin-Resistant Staphylococcus Aureus (MRSA) - This type of infection is resistant to many antibiotics and can cause severe skin infections, pneumonia, bloodstream infections and surgical site infections.
2. Methicillin-Sensitive Staphylococcus Aureus (MSSA) - This type of infection is not resistant to antibiotics and can cause milder skin infections, respiratory tract infections, sinusitis and food poisoning.
Staphylococcal infections are caused by the Staphylococcus bacteria which can enter the body through various means such as:
1. Skin cuts or open wounds
2. Respiratory tract infections
3. Contaminated food and water
4. Healthcare-associated infections
5. Surgical site infections
Symptoms of Staphylococcal infections may vary depending on the type of infection and severity, but they can include:
1. Skin redness and swelling
2. Increased pain or tenderness
3. Warmth or redness in the affected area
4. Pus or discharge
5. Fever and chills
6. Swollen lymph nodes
7. Shortness of breath
Diagnosis of Staphylococcal infections is based on physical examination, medical history, laboratory tests such as blood cultures, and imaging studies such as X-rays or CT scans.
Treatment of Staphylococcal infections depends on the type of infection and severity, but may include:
1. Antibiotics to fight the infection
2. Drainage of abscesses or pus collection
3. Wound care and debridement
4. Supportive care such as intravenous fluids, oxygen therapy, and pain management
5. Surgical intervention in severe cases.
Preventive measures for Staphylococcal infections include:
1. Good hand hygiene practices
2. Proper cleaning and disinfection of surfaces and equipment
3. Avoiding close contact with people who have Staphylococcal infections
4. Covering wounds and open sores
5. Proper sterilization and disinfection of medical equipment.
It is important to note that MRSA (methicillin-resistant Staphylococcus aureus) is a type of Staphylococcal infection that is resistant to many antibiotics, and can be difficult to treat. Therefore, early diagnosis and aggressive treatment are crucial to prevent complications and improve outcomes.
Surgical wound infections can be caused by a variety of factors, including:
1. Poor surgical technique: If the surgeon does not follow proper surgical techniques, such as properly cleaning and closing the incision, the risk of infection increases.
2. Contamination of the wound site: If the wound site is contaminated with bacteria or other microorganisms during the surgery, this can lead to an infection.
3. Use of contaminated instruments: If the instruments used during the surgery are contaminated with bacteria or other microorganisms, this can also lead to an infection.
4. Poor post-operative care: If the patient does not receive proper post-operative care, such as timely changing of dressings and adequate pain management, the risk of infection increases.
There are several types of surgical wound infections, including:
1. Superficial wound infections: These infections occur only in the skin and subcutaneous tissues and can be treated with antibiotics.
2. Deep wound infections: These infections occur in the deeper tissues, such as muscle or bone, and can be more difficult to treat.
3. Wound hernias: These occur when the intestine bulges through the incision site, creating a hernia.
4. Abscesses: These occur when pus collects in the wound site, creating a pocket of infection.
Surgical wound infections can be diagnosed using a variety of tests, including:
1. Cultures: These are used to identify the type of bacteria or other microorganisms causing the infection.
2. Imaging studies: These can help to determine the extent of the infection and whether it has spread to other areas of the body.
3. Physical examination: The surgeon will typically perform a physical examination of the wound site to look for signs of infection, such as redness, swelling, or drainage.
Treatment of surgical wound infections typically involves a combination of antibiotics and wound care. In some cases, additional surgery may be necessary to remove infected tissue or repair damaged structures.
Prevention is key when it comes to surgical wound infections. To reduce the risk of infection, surgeons and healthcare providers can take several steps, including:
1. Proper sterilization and disinfection of equipment and the surgical site.
2. Use of antibiotic prophylaxis, which is the use of antibiotics to prevent infections in high-risk patients.
3. Closure of the incision site with sutures or staples to reduce the risk of bacterial entry.
4. Monitoring for signs of infection and prompt treatment if an infection develops.
5. Proper wound care, including keeping the wound clean and dry, and changing dressings as needed.
6. Avoiding unnecessary delays in surgical procedure, which can increase the risk of infection.
7. Proper patient education on wound care and signs of infection.
8. Use of biological dressings such as antimicrobial impregnated dressings, which can help reduce the risk of infection.
9. Use of negative pressure wound therapy (NPWT) which can help to promote wound healing and reduce the risk of infection.
10. Proper handling and disposal of sharps and other medical waste to reduce the risk of infection.
It is important for patients to follow their healthcare provider's instructions for wound care and to seek medical attention if they notice any signs of infection, such as redness, swelling, or increased pain. By taking these precautions, the risk of surgical wound infections can be significantly reduced, leading to better outcomes for patients.
SmithKline Corp. v. Eli Lilly & Co.
Side effects of penicillin
Posterolateral corner injuries
Oregon National Primate Research Center
List of drugs: Cb-Ce
ATCvet code QJ51
WHO Model List of Essential Medicines
List of β-lactam antibiotics
List of MeSH codes (D02)
WHO Model List of Essential Medicines for Children
Cefazolin Injection: MedlinePlus Drug Information
NHANES 2001-2002: Methicillin - Resistant Staphylococcus aureus (MRSA) Data Documentation, Codebook, and Frequencies
Staphylococcal Infections Medication: Antibiotics, Antibiotic
Pre-operative Prophylaxis With Vancomycin and Cefazolin in Pediatric Cardiovascular Surgery Patients
Is cefazolin a sulfa drug? - Answers
A randomized controlled trial to compare antibiotic prophylaxis in elective gynecological surgeries: Single dose of cefazolin...
Notes from the Field: First Reported Case of Shewanella haliotis in the Region of the Americas - New York, December 2018 | MMWR
Bacteroides thetaiotaomicron (ampicillin-resistant cefazolin-resistant) | The Antimicrobial Index Knowledgebase - TOKU-E
Table 2 - New Delhi Metallo-β-Lactamase in Klebsiella pneumoniae and Escherichia coli, Canada - Volume 17, Number 1-January...
Isolate Details | Antimicrobial Resistance Isolate Bank | Antibiotic/Antimicrobial Resistance | CDC
Cefazolin Monotherapy Versus Cefazolin Plus Aminoglycosides for Antimicrobial Prophylaxis of Type III Open Fractures<...
Medication Prescribing Error Reporting and Prevention Program
Ampicillin/sulbactam Disease Interactions - Drugs.com
The Role of Antibiotics in Cutaneous Surgery: Overview, Skin Florae, Prevention of Infective Endocarditis
Penicillin versus anti-staphylococcal beta-lactams for penicillin-susceptible Staphylococcus aureus blood stream infections: a...
Lasix, Furoscix (furosemide) dosing, indications, interactions, adverse effects, and more
AAHKS Position Statement on CDC Guideline: Post-Operative Prophylactic Antibiotics | AAHKS
MESH TREE NUMBER CHANGES - 2008 MeSH
Assessment of implementation of antibiotic stewardship program in surgical prophylaxis at a secondary care hospital in Ras Al...
Group B Streptococcal Disease
Group B Streptococcal Disease
Recommendations for Preventing the Spread of Vancomycin Resistance
Evidence on Group B Strep in Pregnancy
- The investigators hope to learn 1) if the addition of prophylaxis with vancomycin will decrease the rate of cefazolin non-susceptible surgical site infections (SSI), in high risk population 2) to develop better understanding of vancomycin and cefazolin pharmacokinetics in children undergoing cardiopulmonary bypass (CPB) 3) to assess the barriers to vancomycin dosing peri-operatively 4) to assess side effects and risks associated with peri-operative vancomycin administration. (stanford.edu)
- This data will be compared with 936 controls who received only Cefazolin pre-operatively as prophylaxis for SSI's. (stanford.edu)
- Background:There are conflicting recommendations between organizations regarding aminoglycoside use for the prophylaxis of type III open fractures.Study Question:To compare cefazolin monotherapy versus cefazolin plus aminoglycoside therapy for prophylaxis of type III open fractures in trauma patients.Study Design:This was a multicenter, retrospective, cohort study conducted in 3 academic medical centers in the United States. (arizona.edu)
- Acute kidney injury occurred in 0 of 39 (0%) in the cefazolin monotherapy group and 1 of 95 (1%) in the cefazolin plus aminoglycoside group (P = 1.000).Conclusions:Cefazolin monotherapy may be appropriate for antimicrobial prophylaxis of type III open fractures in trauma patients. (arizona.edu)
- Perioperative cefazolin prophylaxis in hip fracture surgery. (aahks.org)
- Cefazolin injection is also sometimes used for certain penicillin allergic patients who have a heart condition and are having a dental or upper respiratory tract (nose, mouth, throat, voice box) procedure, in order to prevent them from developing a heart valve infection. (medlineplus.gov)
- Cefazolin injection is also sometimes used to treat certain penicillin allergic women who are in labor in order to prevent the newborn from developing an infection. (medlineplus.gov)
- Did the newborn's mother receive intravenous penicillin, ampicillin, or cefazolin ≥4 hours before delivery? (cdc.gov)
- S. pneumoniae was further tested against penicillin, clindamycin, and cefazolin, and H. influenzae was tested against ampicillin. (keywen.com)
- This will allow us to improve patient care by better understanding the benefits or the risks of peri-operative vancomycin administration and potentially decrease cefazolin-resistant surgical site infections. (stanford.edu)
- In addition, this study gives us the opportunity to evaluate cefazolin and vancomycin pharmacokinetics (pK) on children on CPB. (stanford.edu)
- In 10 patients the investigators will do Cefazolin pK analysis and in the other 10 the investigators will do pK Vancomycin analysis. (stanford.edu)
- Comparison of the effects of prophylactic antibiotic therapy and cost-effectiveness between cefazolin (CEZ) and Sulbactam/Ampicillin (SBT/ABPC) in gastric cancer surgery employing clinical pathway]. (bvsalud.org)
- The present study was designed to investigate the effects of prophylactic antibiotic therapy and the cost - effectiveness of Cefazolin (CEZ) and Sulbactam / Ampicillin (SBT/ABPC) in gastric cancer surgery employing clinical pathway . (bvsalud.org)
- Treatment of methicillin-susceptible S aureus (MSSA) bacteremia with cefazolin has been shown to improve survival rates and decrease toxicity in comparison to antistaphylococcal penicillins. (medscape.com)
- [ 55 ] The addition of daptomycin to cefazolin or cloxacillin did not result in improved outcomes in patients with MSSA bacteremia. (medscape.com)
- Patients were divided into 2 groups: (1) cefazolin monotherapy versus (2) cefazolin plus aminoglycoside.Measures and Outcomes:The primary outcome measure was the occurrence of infection at the open fracture site. (arizona.edu)
- Of these, 39 received cefazolin monotherapy and 95 received cefazolin plus aminoglycoside. (arizona.edu)
- Infection at the open fracture site occurred in 6 of 39 patients (15%) in the cefazolin monotherapy group and 15 of 95 patients (16%) in the cefazolin plus aminoglycoside group (P = 1.000). (arizona.edu)
- Cefazolin injection is in a class of medications called cephalosporin antibiotics. (medlineplus.gov)
- Cefazolin injection also may be used before, during, and sometimes for a brief period after surgery in order to prevent the patient from getting an infection. (medlineplus.gov)
- Antibiotics such as cefazolin injection will not work for colds, flu, or other viral infections. (medlineplus.gov)
- Cefazolin injection comes as a powder to be mixed with liquid, or as a premixed product, to be injected intravenously (into a vein) over a period of 30 minutes. (medlineplus.gov)
- Cefazolin injection can also be given intramuscularly (into a muscle). (medlineplus.gov)
- You may receive cefazolin injection in a hospital or you may administer the medication at home. (medlineplus.gov)
- If you will be receiving cefazolin injection at home, your healthcare provider will show you how to use the medication. (medlineplus.gov)
- You should begin to feel better during the first few days of treatment with cefazolin injection. (medlineplus.gov)
- Use cefazolin injection until you finish the prescription, even if you feel better. (medlineplus.gov)
- If you stop using cefazolin injection too soon or skip doses, your infection may not be completely treated and the bacteria may become resistant to antibiotics. (medlineplus.gov)
- Also tell your doctor if you are allergic to any of the ingredients in cefazolin injection. (medlineplus.gov)
- If you become pregnant while taking cefazolin injection, call your doctor. (medlineplus.gov)
- Cefazolin injection may cause side effects. (medlineplus.gov)
- Twenty-four patients received definitive ASBL treatment (11 cefazolin, 13 flucloxacillin). (nih.gov)
- Is cefazolin a sulfa drug? (answers.com)
- A 36-year-old G4P3* at 39 weeks of gestation was treated with 2 grams of cefazolin IV beginning one hour before her scheduled repeat cesarean section. (phrmafoundation.org)