Tags: Cefoxitin

Toxin-Mediated Infections

Tetanus is a disease of global incidence produced by the toxin of Clostridium tetani. The risk of acquiring it increases in people > 60 years of age and in neonates, especially in Third World countries where poor sanitary conditions predispose to umbilical stump contamination. Immunization campaigns have played a crucial role in bringing about the observed decreasing incidence in the United States. The pathogenesis of tetanus involves the absorption of preformed toxin, or, less commonly, invasion of toxin-producing organisms from contaminated wounds; it may complicate surgical wounds colonized with C tetani.

Group B Streptococcus (S Agalactiae) Clinical Syndromes

Early-onset group B streptococcal neonatal infection has three major clinical expressions: bacteremia with no identifiable focus of infection, pneumonia, and meningitis (Box 1). Signs and symptoms of early-onset group B streptococcal neonatal infection include lethargy, poor feeding, jaundice, abnormal temperature, grunting respirations, pallor, and hypotension.

Order Amoxil (Amoxicillin) Without Prescription 500mg

Amoxicillin, an acid stable, semi-synthetic drug belongs to a class of antibiotics called the Penicillins (beta-lactam antibiotics). It is shown to be effective against a wide range of infections caused by wide range of Gram-positive and Gram-negative bacteria in both human and animals.

Cellulitis

An acute, spreading infection of the dermis and subcutaneous tissue. Several entities are recognized: Treat 10-30 days. Guided by culture results whenever possible.

Anaerobic & Necrotizing Infections

Gangrene is local death of soft tissues due to disease or injury and is associated with loss of blood supply. Anaerobic and necrotizing infections may be associated with gas.

Anti-Infective Agent Dosing

The characteristics that need to be considered when administering antibiotics include absorption (when dealing with oral antibiotics), volume of distribution, metabolism, and excretion. These factors determine the dose of each drug and the time interval of administration. To effectively clear a bacterial infection, serum levels of the antibiotic need to be maintained above the minimum inhibitory concentration for a significant period. For each pathogen, the minimum inhibitory concentration is determined by serially diluting the antibiotic into liquid medium containing 104 bacteria per millihter.

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.

Surgical Prophylaxis

The traditional classification system developed by the National Research Council  stratifying surgical procedures by infection risk is reproduced in Table NRC Wound Classification, Risk of SSI, and Indication for Antibiotics. The National Research Council wound classification for a specific procedure is determined intraoperatively.

Skin and Soft Tissue Infections

Impetigo is a superficial skin infection that is seen most commonly in children. It is highly communicable and spreads through close contact. Most cases are caused by S. pyogenes, but S. aureus either alone or in combination with S. pyogenes has emerged as a principal cause of impetigo.

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.

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