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Pulmonary MAC disease patients from 2010 to 2012 were divided into two groups, those who received LVFX together with CAM (LVFX group) and those who received CAM without LVFX (control group). The number of patients who showed improvement was evaluated at 1, 3, 6 and 12 months after the start of therapy based on bacteriological examination (culture and smear examination) and the bacilli negative conversion rate.
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An open-label, non-randomized, single and multiple dose clinical trial was conducted. In single dose study, 12 subjects took 200 mg antofloxacin hydrochloride. In multiple dose study, 12 subjects took antofloxacin hydrochloride 400 mg once on day 1 and 200 mg once daily from day 2 to day 7. HPLC was used to assay the serum and urinary concentrations of antofloxacin.
Of the 28 307 E. coli blood isolates, 27.9% were ciprofloxacin non-susceptible (CIPNS), increasing from 17.6% in 2001 to 32.7% in 2009. A continuous increase was observed between CIPNS and other resistances, including cephalosporin resistance due to the production of extended-spectrum β-lactamases (ESBLs) and non-susceptibility to both amoxicillin/clavulanic acid and tobramycin. Although the total use of antibiotics did not increase, community use of levofloxacin, moxifloxacin and amoxicillin/clavulanic acid increased by 307.2%, 62.6% and 70.1%, respectively. Yearly rates of CIPNS E. coli strongly correlated with the use of levofloxacin, moxifloxacin and amoxicillin/clavulanic acid (r(2 )> 0.80; P < 0.005 in all cases).
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In the studied real-life setting, we found a considerable number of MQAB users with additional risk factors for TdP but no ECG monitoring. However, adverse drug reactions were rarely found, and costs vs. benefits of ECG monitoring have to be weighted. In contrast, avoidable risk factors and selected contraindicated pharmacokinetic interactions are clear targets for implementation as automated alerts in electronic prescribing systems.
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The mRNA expression levels of TLR2, TLR4, and MD-2 in liver tissue of alcohol-induced liver disease with VV sepsis, which may be reduced by treatment of cefoperazone sodium and LVFX, are associated with the development of VV sepsis. This treatment is effective on this disease. Dynamic monitoring of the mRNA expression levels of TLR2, TLR4, and MD-2 in liver tissue benefits observation of the VV sepsis progress and treatment.
University-based primary health care clinic.
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Two community-based hospitals in the Houston, Texas, region.
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To determine the antibiotic susceptibility of preoperative conjunctival bacterial flora.
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S. maltophilia is an uncommon causative agent of endophthalmitis and is resistant to commonly used antibiotics, such as ceftazidime and aminoglycosides. Based on in vitro antibiotic susceptibility testing, sulfamethoxazole-trimethoprim and new-generation fluoroquinolones may be preferable in the treatment of endophthalmitis caused by S. maltophilia.
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Laboratory data and symptoms on admission indicated DIC.
Resistance of Streptococcus pneumoniae to fluoroquinolones arises by stepwise accumulation of spontaneous point mutations in the quinolone-resistance determining regions (QRDRs). Fluoroquinolones treatment of infections caused by first-step mutants (pre-resistant) can lead to the selection of resistant isolates, resulting in treatment failure. First-step mutants cannot however be reliably detected by routine resistance testing. Levofloxacin has been used as a surrogate marker to predict fluoroquinolone susceptibility in clinical laboratories. By use of a PCR followed by pyrosequencing, we examined 45 levofloxacin-susceptible pneumococcal strains [minimal inhibitory concentration (MIC) < 0.5 μg/ml] for first-step parC and parE mutations in the QRDR: 51.2% of isolates were recovered from pulmonary and nasal secretions, 22.2% from blood, 24.4% from ear and eye discharge, and 2.2% from cerebrospinal fluid. The results showed that three strains (6.6%) had first-step parC (Asp83-Asn) or parE (Asp435-Asn) mutations. This test could be useful for some high-risk patients or in national surveys.
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A total of 265 (265/748, 35.4%) strains of ESBLs-producing Escherichia coli and 56 (56/266, 21.1%) strains of Klebsiella pneumoniae were isolated between 2004 and 2005, respectively. There were 15 patients with ESBLs-producing sepsis (M/F: 8/7, age 11 - 82 yr) and 16 with non-ESBLs-producing sepsis (M/F: 5/11, age 7 d-84 yr). The frequent origins of infection in the 2 groups were respiratory system, peritoneal cavity and reproductive system. No statistical difference was found between the 2 groups in clinical symptoms such as temperature, fever type, respiratory rate, heart rate, shock, white blood cells. Pitt bacteremia score and APACHE II score (all P > 0.05). No statistical difference was found between the 2 groups in risk factors such as length of hospital stay before pathogen isolation, length of ICU stay, use of mechanical ventilation, duration of mechanical ventilation, use of central venous catheter, glucocorticosteroids or immunosuppressants, histamine-2-receptor agonists, urinary catheter, operation, gastric tube, total parenteral nutrition, previous hospital admission, anemia and hypoalbuminemia (all P > 0.05). However, the number of use of third-generation cephalosporin given 2 weeks before strains isolation was 9 in case patients (9/11) and 3 in control patients (3/10, chi(2) = 5.743, P < 0.05). The antibiotic resistance rate of ESBLs-producing Escherichia coli and Klebsiella pneumoniae increased significantly, including piperacillin (9 vs. 5, chi(2) = 7.013, P < 0.01), cefepime (7, 0, chi(2) = 7.467, P < 0.01), ceftazidime (9, 1, chi(2) = 11.317, P < 0.01), cefoperazone/sulbactam (11, 2, chi(2) = 11.780, P < 0.01), levofloxacin (12, 7, chi(2) = 5.662, P < 0.05). Five in case patients (5/15) and 2 in control patients (2/16) died.