Tags: Cefoperazone

Infection in Patients With Aids

Paeruginosa infections may occur in patients with AIDS. Risk factors for infection include a CD4 count of < 100 cells/mL3, neutropenia or functional neutrophil defects, intravascular catheterization, hospitalization, and prior use of antibiotics including ciprofloxacin or trimethoprim-sulfamethoxazole. Many cases are community acquired. Bacteremia is common, and the lung or an intravenous catheter is the most frequent portal of entry.

Specific Anti-Infective Agents

Clinicians should be familiar with the general classes of antibiotics, their mechanisms of action, and their major toxicities. The differences between the specific antibiotics in each class can be subtle, often requiring the expertise of an infectious disease specialist to design the optimal anti-infective regimen. The general internist or physician-in-training should not attempt to memorize all the facts outlined here, but rather should read the pages that follow as an overview of anti-infectives. The chemistry, mechanisms of action, major toxicities, spectrum of activity, treatment indications, pharmacokinetics, dosing regimens, and cost are reviewed.

Central Nervous System Infections

Central nervous system infections include a wide variety of clinical conditions and etiologies: meningitis, meningoencephalitis, encephalitis, brain and meningeal abscesses, and shunt infections. The focus of this chapter is meningitis. N. meningitidis meningitis is the leading cuase of bacterial meningitis in children and young adults in the United States.

Antimicrobial Regimen Selection

A generally accepted systematic approach to the selection and evaluation of an antimicrobial regimen is shown in Table Systematic Approach for Selection of Antimicrobials. An «empiric» antimicrobial regimen is begun before the offending organism is identified, while a «definitive» regimen is instituted when the causative organism is known. The use of combinations to prevent the emergence of resistance is widely applied but not often realized. The only circumstance where this has been clearly effective is in the treatment of tuberculosis.

Antimicrobial therapy: general principles

A wide variety of antimicrobial agents is available to treat established infections caused by bacteria, fungi, viruses, or parasites. This section will cover the general principles of antimicrobial therapy and will also include illustrative clinical problems to emphasize proper decision-making in using antimicrobials.

Toxicity of Antimicrobial Therapy

The mechanisms associated with common adverse reactions to antimicrobials include dose-related toxicity that occurs in a certain fraction of patients when a critical plasma concentration or total dose is exceeded, and toxicity that is unpredictable and mediated through allergic or idiosyncratic mechanisms. For example, certain classes of drugs such as the aminoglycosides are associated with dose-related toxicity.

Ticarcillin Disodium and Clavulanate Potassium

Adverse effects reported with ticarcillin disodium and clavulanate potassium are similar to those reported with ticarcillin alone. For information on adverse effects reported with ticarcillin and other extended-spectrum penicillins, see Cautions in the Extended-Spectrum Penicillins General Statement 8:12.16.16. Rash, pruritus, urticaria, and fever have been reported with ticarcillin disodium and clavulanate potassium.

Piperacillin Sodium and Tazobactam Sodium

Piperacillin sodium and tazobactam sodium is used parenterally for the treatment of moderate to severe infections caused by, or suspected of being caused by, susceptible b-lactamase-producing bacteria when piperacillin alone would be ineffective.

Order Ampicillin (Principen) No Prescription 250/500mg

Ampicillin sodium and sulbactam sodium is used parenterally for the treatment of skin and skin structure, intra-abdominal, and gynecologic infections caused by susceptible bacteria. The drug also has been used parenterally for the treatment of other infections, including respiratory tract infections caused by susceptible bacteria.

Order Augmentin (Amoxicillin) Without Prescription

Amoxicillin and clavulanate potassium is used orally for the treatment of lower respiratory tract infections, otitis media, sinusitis, skin and skin structure infections, and urinary tract infections caused by susceptible organisms. Amoxicillin and clavulanate potassium also has been used orally for the treatment of chancroid and gonorrhea caused by susceptible organisms. Amoxicillin and clavulanate potassium has been effective when used orally in adults and children for the treatment of abscesses, cellulitis, and impetigo caused by susceptible penicillinase-producing and nonpenicillinase-producing Staphylococcus aureus and S. epidermidis, Streptococcus pyogenes (group A b-hemolytic streptococci), or Corynebacterium. Results of several controlled studies indicate that amoxicillin and clavulanate potassium is as effective as cefaclor in the treatment of these infections.