Tags: Netilmicin

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.

Enterococci

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.

Brucellosis

Systemic bacterial infection caused by Brucella species in infected animal products, or vaccine. Incubation period usually 5-60 days, but highly variable and may be several months.

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.

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.

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.

Aminoglycosides – antibiotic agents

Aminoglycosides are very potent bactericidal antibiotic agents that are active against susceptible aerobic microorganisms. They kill by inhibiting protein synthesis and to some extent by lysing the cell envelope. All the aminoglycosides (streptomycin, kanamycin, neomycin, gentamicin, amikacin, tobramycin, sisomicin, and netilmicin) share common structural features. Streptomycin is used once a day in combination with other antibiotics to treat mycobacterial infections.

Aminoglycosides: Amikacin, Gentamicin, Kanamycin, or Tobramycin

Amikacin, gentamicin, kanamycin, or tobramycin is used IM or IV in the short-term treatment of serious infections such as septicemia (including neonatal sepsis), bone and joint infections, skin and soft tissue infections (including those resulting from burns), respiratory tract infections, and postoperative and intra-abdominal infections (including peritonitis) caused by susceptible strains of gram-negative bacteria.

Extended-Spectrum Penicillins General Statement

Oral carbenicillin indanyl sodium is used only for the treatment of acute or chronic infections of the upper and lower urinary tract, asymptomatic bacteriuria, or prostatitis caused by susceptible organisms.

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