• 제목/요약/키워드: broad-spectrum antibiotics

검색결과 119건 처리시간 0.024초

대학병원의 Formulary로 선정되어 사용 중인 원내 퀴놀론 주사제의 약물사용에 대한 평가 (Evaluation of Inpatient Use for IV Quinolones in an University Hospital Formulary)

  • 김훈희;이옥상;정선회;임성실
    • 한국임상약학회지
    • /
    • 제22권1호
    • /
    • pp.55-64
    • /
    • 2012
  • The quinolones are broad-spectrum antibiotics and enhanced antimicrobial activity has extended the use of the quinolones beyond the traditional indications for quinolone antibiotics in the treatment of urinary tract infections. The quinolones are effective in a wider variety of infectious diseases, including skin and respiratory infections. Because of their excellent safety and tolerability, they have become popular alternatives to penicillin and cephalosporin derivatives in the treatment of various infections. A retrospective study was performed to evaluate efficacy and safety of IV quinolones for inpatient use. Total 117 patients who administerd quinolones for longer than 3 continuous days at community hospital from October 1st, 2008 to December 31st, 2008 were reviewed. The criterias for drug evaluation were included the validation of indication, outcome, dosage and side effects. In the results, ciprofloxacin 13 (total 93), levofloxacin 3 (total 59) and moxifloxacin 2 (total 19) cases were not met the criterias based on the culture results. Major indications were pneumonia (ciprofloxacin 16.3%, levofloxacin 67.8%, moxifloxacin 84.2%), urinary tract infection (ciprofloxacin 44.1%), skin infection (ciprofloxacin 7.5%, levofloxacin 20.3%, moxifloxacin 10.5%), intra-abdominal infection (ciprofloxacin 10.8%, moxifloxacin 5.3%), etc.. In the results of quinolone monotherapy, the frequencies were each ciprofloxacin 74.2%, levofloxacin 50.8% and moxifloxacin 47.4%. In the results of dosage validation, the validities were each ciprofloxacin 54.8%, levofloxacin 94.9% and moxifloxacin 100.0%. In the results of duration validation, the validities were each ciprofloxacin 59.1%, levofloxacin 78.0% and moxifloxacin 89.5%. Adverse drug reactions were reported for total 49 cases and those were gastrointestinal tract effects including nausea, vomiting, diarrhea and central nervous system effects including headache, dizziness. In summary, the quinolones appropriately used for hospitalized patients based on this study. A focused approach emphasizing "correct use of quinolones" may reduce development of antimicrobial resistance and maximize class efficacy. Consequently, correct use of antibiotics will contribute to decrease medical expenses for person and community.

Antimicrobial Activity of a Bacteriocin Produced by Enterococcus faecalis KT11 against Some Pathogens and Antibiotic-Resistant Bacteria

  • Abanoz, Hilal Seval;Kunduhoglu, Buket
    • 한국축산식품학회지
    • /
    • 제38권5호
    • /
    • pp.1064-1079
    • /
    • 2018
  • In this study, the antimicrobial activity of a bacteriocin produced by Enterococcus faecalis KT11, isolated from traditional Kargı Tulum cheese, was determined, and bacteriocin KT11 was partially characterized. The results showed that bacteriocin KT11 was antagonistically effective against various Gram-positive and Gram-negative test bacteria, including vancomycin- and/or methicillin-resistant bacteria. The activity of bacteriocin KT11 was completely abolished after treatment with proteolytic enzymes (proteinase K, ${\alpha}$-chymotrypsin, protease and trypsin), which demonstrates the proteinaceous nature of this bacteriocin. Additionally, bacteriocin KT11 remained stable at pH values ranging from 2 to 11 and after autoclaving at $121^{\circ}C$ for 30 min. In addition, the activity of bacteriocin KT11 was stable after treatment with several surfactants (EDTA, SDS, Triton X-100, Tween 80 and urea) and organic solvents (chloroform, propanol, methanol, ethyl alcohol, acetone, hexane and ethyl ether). Cell-free supernatant of E. faecalis KT11 was subjected to ammonium sulfate precipitation and then desalted by using a 3.5-kDa cut-off dialysis membrane. The bacteriocin activity was determined to be 711 AU/mL in the dialysate. After tricine-SDS-PAGE analysis, one peptide band, which had a molecular weight of ~3.5 kDa, exhibited antimicrobial activity. Because the bacteriocin KT11, isolated from E. faecalis KT11, exhibits a broad antimicrobial spectrum, heat stability and stability over a wide pH range, this bacteriocin can be used as a potential bio-preservative in foods. Additionally, bacteriocin KT11 alone or in combination with conventional antibiotics may provide a therapeutic option for the treatment of multidrug-resistant clinical pathogens after further in vivo studies.

발톱에 발생한 역행조갑 환자의 치험례 (A Case of Retronychia on Toenail)

  • 최석민;김철한;강상규;탁민성
    • Archives of Plastic Surgery
    • /
    • 제37권2호
    • /
    • pp.178-181
    • /
    • 2010
  • Purpose: Retronychia is the embedding of the nail into proximal nail fold. Retronychia starts with disruption of the longitudinal growth of the nail. With the growth of a new nail, the old one is pushed upwards and backwards. This leads to embedding of the top nail into the ventral aspect of the proximal nail fold and results with chronic paronychia. We present a case of retronychia that was rarely reported in the literature. Methods: A 46-year old female presented with a 3-month history of painful right first, 2nd, 3rd toenail changes. Although she was initially treated with broad spectrum antibiotics, she did not response to therapy. Later, she presented to our department because of progressively worsening pain that impaired her walking. Physical examination revealed with proximal nail fold erythema, painful swelling, yellowish nail discoloration, and distal onycholysis. Bacterial and fungus culture showed no organism. Treatment was surgical nail avulsion under local anesthesia. Results: The postoperative course was uneventful. 10 months later, the patient had a normal growing nail and was free of symptoms. Conclusion: We report a case of retronychia on toenail. Retronychia is a proximal nail plate ingrowth into the proximal nail fold which is associated with multiple generations of nail plate misaligned beneath the proximal nail. Management consisted of simple avulsion of superimposed nail. Retronychia is suspected with a persistent paronychia, particularly in the setting of trauma. Avulsion of the top nail confirms the diagnosis and may be curative if the underlying nail appears healthy.

Docetaxel과 Cisplatin으로 치료한 비소세포폐암환자에서 발생한 BOOP 1예 (Bronchiolitis Obliterans Organizing Pneumonia in the Patient with Non-Small Cell Lung Cancer Treated with Docetaxel/Cisplatin Chemotherapy: A Case Report)

  • 김애란;김태영;이영민;이승헌;정수진;이현경
    • Tuberculosis and Respiratory Diseases
    • /
    • 제69권4호
    • /
    • pp.293-297
    • /
    • 2010
  • A 60-year-old man was diagnosed with stage IV squamous cell carcinoma of lung and treated with weekly doses of docetaxel and cisplatin. Tumor mass and mediastinal lymphadenopathy disappeared after 4.5 cycles of chemotherapy. At one week post final chemotherapy, the patients developed sudden shortness of breath. New, multifocal infiltrations developed on both lungs without definitive evidence of infection. Despite administration of broad spectrum antibiotics, the lung lesion did not improve, so bronchoalveolar lavage and computed tomography-guided lung biopsy were performed. The proportion of lymphocytes was increased markedly and histopathology revealed squamous cell carcinoma combined with bronchiolitis obliterans organizing pneumonia. After high dose corticosteroid therapy, dyspnea and the newly developed consolidation had decreased slightly. However, dyspnea and hypoxemia increased again because of aggravated lung cancer since chemotherapy had stopped. Chemotherapy couldn't be restarted due to the poor performance status of the patient. Later, patient died of respiratory failure from poor general condition and progression of lung cancer.

염산피밤피실린의 마이크로캅셀에 관(關)한 약제학적(藥劑學的) 연구(硏究) (Pharmaceutical Studies on Microencapsulated Pivampicillin Hydrochloride)

  • 이완하;지웅길;이영환;김상린
    • Journal of Pharmaceutical Investigation
    • /
    • 제15권2호
    • /
    • pp.53-62
    • /
    • 1985
  • Pivampicillin hydrochloride is a kind of broad spectrum antibiotics with bactericidal action, and is used in many countries, although it has bitter taste, unpleasant odour and side effects of irritating gastric mucosa, nausea, penicillin allergy, etc. For the improvement of such side effects of pivampicillin hydrochloride, microcapsules, with wall of ethylcellulose, have been prepared by coacervation method. The shape was observed through the scanning electron microscope, the release of the drug into an aqueous medium was studied and the effects of core: ethylcellulose ratio were interpreted as well as making sensory evaluation of taste and odour. There was decreasing trend in dissolution rate of the drug with the increase of core: ethylcellulose ratios, and the smaller microcapsules released their contents more rapidly. A linear relationship was established between the amount of ethylcellulose and the time for 60% release of the drug, and the release pattern was found to have similar characteristics to the release of the drug from an insoluble porous matrix. The release of the drug in the artificial intestinal fluids (pH 6.8) was found to be similar to that in water, while the release in the artificial gastric juice (pH 1.2) was slightly slower. Bioavailability of microcapsule was compared with that of pivampicillin hydrochloride in rabbits using serum concentration and urinary excretion measurements. Microcapsule gave showed slightly higher serum level than pivampicillin hydrochloride from 2 hours after administration, while no significant difference was observed in the accumulated urinary excretion rate between pivampicillin hydrochloride and microcapsule. The ulcer index of pivampicillin hydrochloride administered group was 2.6, and microcapsule administered group was 1.5, while control group was 0.8. Therefore it may be concluded that microencapsulation of pivampicillin hydrochloride is a useful pharmaceutical approach to protect the gastrointestinal tract from being injured by direct contact of pivampicillin hydrochloride without any significant difference of bioavailability.

  • PDF

고추 재배토양(栽培土壤)에서 Phytophthora capsid에 길항효과(拮抗效果)가 있는 항생작물생성(抗生物質生成) 방선균(放線菌)의 분리(分離) (Isolation of Antibiotic-Producing Actinomycetes Antagonistic to Phytophthora capsici from Pepper-Growing Soils)

  • 안상준;황병국
    • 한국균학회지
    • /
    • 제20권3호
    • /
    • pp.259-268
    • /
    • 1992
  • 6개 고추재배지의 근권 및 해안가 토양으로부터 고추 역병균(Phytophthora capsici)과 벼 도열병균(Magnaporthe grisea)에 길항효과가 있는 53개의 방선균을 분리하였다. 분리된 방선균 중에서 고추 역병균의 균사생장을 억제시켜 5 mm 이상 저지원을 형성하는 32균주를 선발하여 이들 균주의 균총형태, 색깔 등에 따라 20군으로 유별하였다. 이들 길항방선균의 고추 역병균에 대한 길항효과는 균주간에 매우 다양하여 V-8 juice agar에서 5.7-17.5, tryptic soy agar에서는 2.5-l7mm의 저지효과를 보였다. 몇가지 방선균의 길항효과는 두 배지에서 상당히 다르게 발현되었다. 길항균들은 비교적 넓은 항진균성 스펙트럼을 나타내었으나, 세균에 대해서는 Pseudomonas solanacearum을 제외하고는 항균작용이 거의 없었다. 길항방선균 배양여액의 butanol 추출액이 고추 역병균과 벼도열병균의 균사생장을 억제하는 것으로 보아서 이들 길항균이 항균물질을 생성함을 강하게 시사하고 있다. 몇가지 길항방선균의 배양여액은 고추 역병방제 효과가 뚜렷하였다.

  • PDF

식품위해성균, 피부사상균 및 식물성 병원균에 대한 산초유의 항균 활성 및 항산화 활성 (Antimicrobial Activity against Food-hazardous Microorganisms, Dermatophytes, and Pytopathogens and Antioxidative Activity of Sancho Oil)

  • 김학곤;강승미;용성현;설유원;최은지;박준호;유찬열;;최명석
    • 한국약용작물학회지
    • /
    • 제28권1호
    • /
    • pp.38-46
    • /
    • 2020
  • Background: Although Sancho (Zanthoxylum schinifolium Siebold & Zucc) oil has traditionally been used for its antibiotics properties, there is currently a lack of scientific evidence regarding its biological activities. In this study, we investigated the antimicrobial and antioxidant activities of Sancho oil against food-hazardous microorganisms, phytopathogens, and dermatophytes. Methods and Results: We investiated the antimicrobial activity of Sancho oil against 11 food-hazardous microorganisms, nine phytopathogens, and six dermatophytes. The Sancho oil was found to show the strongest antibacterial activity against Shigella flexneri and Listeria spp. Sancho oil also showed high antifungal activity against plant pathogens, particularly Fusarium oxysporum, and showed antimicrobial activity against dermatophytes such as Trichophyton rubrum, Microsporum canis and Candida albicans. The antioxidant activity of Sancho oil was measured using the DPPH method, and was found to be stronger than that of unrefined oil. Moreover, this activity increased with increasing oil concentration. Conclusions: We found that Sancho oil showed differing antimicrobial activities against food-hazardous microorganisms, dermatophytes, and plant pathogens. The antimicrobial activity spectrum of Sancho oil was not broad and varied among microbial strains. On the basis of our findings, we consider that Sancho oil could be used an antibacterial material for food-borne S. flexneri and Listeria spp., a biopesticide for Fusarium spp., and a treatment for dermatophytes such as T. rubrum.

인공호흡기연관 폐렴 (Ventilator-Associated Pneumonia)

  • 전경만
    • Tuberculosis and Respiratory Diseases
    • /
    • 제70권3호
    • /
    • pp.191-198
    • /
    • 2011
  • Ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in the intensive care unit (ICU), with an incidence ranging from 8% to 38%. Patients who acquire VAP have higher mortality rates and longer ICU and hospital stays. Because there are other potential causes of fever, leukocytosis, and pulmonary infiltrates, clinical diagnosis of VAP is overly sensitive. The only alternative approach to the clinical diagnosis of VAP is the Clinical Pulmonary Infection Score (CPIS). Employing quantitative cultures of respiratory secretions in the diagnosis of VAP leads to less antibiotic use and probably to lower mortality. With respect to microbiologic diagnosis, however, it is not clear that the use of invasive sampling using bronchoscopy is associated with better outcomes. Delayed administration of antibiotic therapy is associated with an increased mortality, and inadequate antibiotic therapy is also associated with higher mortality. Therefore, prompt initiation of adequate antibiotic therapy is a cornerstone of the treatment of VAP. The initial antibiotic therapy should be based on the most common organisms in each hospital and the most likely pathogens for that specific patient. When final cultures and susceptibilities are available, de-escalation to less broad spectrum antibiotics should be done. Since clinical improvement usually takes 2 to 3 days, clinical responses to the initial empirical therapy should be evaluated by day 3. A short course of antibiotic therapy appears to be equivalent to a traditional course of more than 14 days, except when treating non-fermenting gram-negative organisms. If patients receive initially adequate antibiotic therapy, efforts should be made to shorten the duration of therapy to as short as 7 days, provided that the etiologic pathogen is not a non-fermenting gram-negative organism.

An Elderly Man with Fatal Respiratory Failure after Eating a Poisonous Mushroom Podostroma cornu-damae

  • Jang, Juah;Kim, Cheol-Hong;Yoo, Jun Jae;Kim, Mi Kang;Lee, Jae Eun;Lim, Ah Leum;Choi, Jeong-Hee;Hyun, In Gyu;Shim, Jung Weon;Shin, Ho-Seung;Han, Joungho;Seok, Soon Ja
    • Tuberculosis and Respiratory Diseases
    • /
    • 제75권6호
    • /
    • pp.264-268
    • /
    • 2013
  • A 73-year-old, previously healthy man presented with nausea, vomiting, diarrhea, dry mouth and febrile sensation 3 hours after eating boiled wild mushrooms. After admission, he showed progressive severe respiratory distress, pancytopenia, azotemia, hypotension, hypoxemia and consolidation of the entire left lung on chest radiography. With a preliminary diagnosis of necrotizing pneumonia, he underwent left pneumonectomy in order to remove all necrotic lung tissue. Lung histology showed extensive hemorrhagic necrosis, massive inflammatory cell infiltration, prominent proliferation of young fibroblasts and the formation of an early-stage hyaline membrane along the alveolar wall. Despite aggressive treatment, including mechanical ventilation, continuous renal replacement therapy and administration of granulocyte colony stimulating factor and broad spectrum antibiotics, he died on hospitalization day 13. Subsequently, the mushroom was identified as Podostroma cornu-damae. This is the first case of a histological evidence of lung involvement by Podostroma cornu-damae poisoning in Korea.

전신성 홍반성 루푸스 환자에서 발생한 괴사성 근막염의 치험례 (Necrotizing Fasciitis in a Patient with Systemic Lupus Erythematosus)

  • 조혜인;장학
    • Archives of Plastic Surgery
    • /
    • 제38권3호
    • /
    • pp.309-314
    • /
    • 2011
  • Purpose: Necrotizing fasciitis is a life-threatening, destructive soft tissue infection with a very high rate of mortality that needs early diagnosis and aggressive treatment. Systemic Lupus Erythematosus (SLE) is a systemic, autoimmune disease and it's major cause of mortality is an infection. But necrotizing fasciitis in SLE is very rare and there have been only 22 cases reported in the literatures. We reported a patient of necrotizing fasciitis with SLE and reviewed 22 others from literature research. Methods: A 40-year-old female patient with a history of SLE for 6 years came to the emergency room. The patient complained of severe pain and swelling on her right leg. She was diagnosed as necrotizing fasciitis and underwent emergency fasciotomy. As wound cultures showed variable organisms, she was treated with broad-spectrum antibiotics and underwent several surgical debridements. Then, the wound was treated with the V.A.C (Vacuum Assisted Closure) device and split thickness skin grafting was performed two times. Results: Skin graft was well taken within 2 weeks after operations and the patient was discharged to outpatient follow up. There was no complication related with surgery and she could walk without cane after 3 months. Conclusion: We treated a necrotizing fasciitis in a patient with SLE and reviewed 22 others from literature research. The case presented here suggests that necrotizing fasciitis is a rare disease in SLE patients, but should be considered in the differential diagnosis of soft tissue infection in SLE patients. A high index of suspicion is needed for early diagnosis and proper management in these patients.