Tags: Cycloserine

Tuberculosis

Approximately one-third of the world’s population is infected with M tuberculosis, according to World Health Organization estimates, resulting in 2.9 million annual deaths. In the United States, tuberculosis is on the rise, after several decades of steady decline.

Pulmonary Infections

Acute pneumonia is a potentially life-threatening illness requiring rapid diagnosis and treatment. A delay in antibiotic treatment increases the risk of a fatal outcome. Annually, 2 to 3 million cases of pneumonia are reported in the United States.

Treatment of Tuberculosis

Recommended Drug Regimens for Treatment of Latent Tuberculosis Infection. Drug Regimens for Culture-Positive Pulmonary Tuberculosis Caused by Drug-Susceptible Organisms. Doses of Antituberculosis Drugs for Adults and Children. Tuberculous meningitis and Extrapulmonary disease.

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 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.

Management of Tuberculosis

Tuberculosis was a disappearing disease in North America until the early 1980s. However, the spread of human immunodeficiency virus infection has changed that. From 1985 to 1992 there was an increase in the number of cases of tuberculosis reported in the United States, and most of these cases were in New York, New Jersey, Texas, Florida, and California. The other major change in the epidemiology of tuberculosis has been the emergence of multidrug-resistant disease.

Management of Malaria

Malaria is a protozoan (genus Plasmodium) infection transmitted by the bite of an infected female Anopheles mosquito and rarely via a contaminated blood transfusion. It is extremely common, affecting more than 500 million persons and resulting in more than 1 million deaths each year. There are four species of the genus Plasmodium that cause malaria in man.

Isoniazid – Antituberculosis Agent

Isoniazid usually is administered orally. The drug may be given by IM injection when oral therapy is not possible. The fixed-combination preparation containing isoniazid and rifampin (RifamateĀ®) and the fixed-combination preparation containing isoniazid, rifampin, and pyrazinamide (RifaterĀ®) should be given either 1 hour before or 2 hours after a meal; the manufacturer states that RifaterĀ® should be given with a full glass of water.

Ethionamide

Ethionamide is a synthetic, isonicotinic acid-derivative antituberculosis agent. Ethionamide is used in conjunction with other antituberculosis agents in the treatment of clinical tuberculosis.