Tags: Norfloxacin


Enterococci are able to grow and survive under harsh conditions and can be found in soil, food, water, and a wide variety of animals. The major habitat of these organisms is the gastrointestinal tract of humans and other animals, where they make up a significant portion of the normal gut flora. Most enterococci isolated from human stools are E faecalis, although E faecium are also commonly found in the human gastrointestinal tract. Small numbers of enterococci are occasionally found in oropharyngeal and vaginal secretions and on the skin, especially in the perineal area.

Enterococci: Clinical Syndromes

Urinary tract infections, including uncomplicated cystitis, pyelonephritis, prostatitis, and perinephric abscess, are the most common type of clinical infections produced by enterococci (Box 1). Most enterococcal urinary tract infections are nosocomial and are associated with urinary catheterization or instrumentation. Nosocomial enterococcal bacteremias are commonly polymicrobial. Portals of entry for enterococcal bacteremia include the urinary tract, intra-abdominal or pelvic sources, wounds (especially burns, decubitus ulcers, and diabetic foot infections), intravascular catheters, and the biliary tree.

Norfloxacin: Side Effects

In a double-blind, multicenter study 171 patients who had acute pyelonephritis were given intravenous cefuroxime for 2-3 days, followed by ceftibuten 200 mg bd or norfloxacin 400 mg bd for 10 days. There were fewer bacterial relapses after oral norfloxacin than ceftibuten. Adverse events were reported by 47% of the patients taking ceftibuten and by 38% of those taking norfloxacin. This difference was not significant, but diarrhea or loose stools occurred more often with ceftibuten.

Urinary Tract Infections and Prostatitis

A urinary tract infection is defined as the presence of microorganisms in the urine that cannot be accounted for by contamination. The organisms have the potential to invade the tissues of the urinary tract and adjacent structures.

Syphilis: Primary, Secondary, Latent, Tertiary

Primary syphilis is characterized by the appearance of a chancre on cutaneous or mucocutaneous tissue. Chancres persist only for 1 to 8 weeks before spontaneously disappearing.

Bacterial Infections

Enterotoxigenic (cholera-like) Diarrhea. Escherichia coli. Pseudomembranous Colitis (Clostridium difficile).

Invasive (dysentery-like) Diarrhea

Bacillary Dysentery (Shigellosis). Salmonellosis. Campylobacteriosis.

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.

Infectious disorders

Infectious diseases comprise those illnesses that are caused by microorganisms or their products. Clinical manifestations of infection occur only when sufficient tissue injury has been inflicted directly by microbial products (e.g., endotoxins and exotoxins), or indirectly by host responses (e.g., cytokines and hydrolytic enzymes released by polymorphonuclear leukocytes). Despite the extraordinary recent advances that have occurred in therapeutics for infectious diseases, a number of basic principles should be followed to prescribe antimicrobials and vaccines is an optimal manner.

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.