Randomized, open-label trial. Forty adults with newly diagnosed smear-positive PTB (10 per arm) were assigned to receive isoniazid (INH) 300 mg, levofloxacin 1000 mg, gatifloxacin 400 mg, or moxifloxacin 400 mg daily for 7 days. Sputum for quantitative culture was collected for 2 days before and daily during 7 days of monotherapy. Bactericidal activity was estimated by measuring the decline in bacilli during the first 2 days (EBA 0-2) and last 5 days of monotherapy (extended EBA, EBA 2-7). Laboratory staff were blinded to treatment assignment.
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A total of 329 patients enrolled in the study at 24 centers. All patients had a pre-therapy Gram's stain and culture of sinus exudate obtained by antral puncture or nasal endoscopy. Clinical response was assessed on the basis of signs and symptoms and sinus radiograph or computed tomography results. Microbiologic cure rates were determined on the basis of presumed plus documented eradication of the pre-therapy pathogen(s).
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To determine the steady-state plasma, epithelial lining fluid (ELF), and alveolar macrophage (AM) concentrations of levofloxacin and ciprofloxacin.
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Of the 197 patients, 118(59.9%) were males and 79(40.1%) were females. Moreover, there were 78(39.6%) children and 119(60.4%) adults. The overall mean age was 19.58±13.82 years. Patients with positive culture for salmonella typhi were 155(78.7%) while patients with positive cultures for salmonella paratyphi A were 42(21.3%). No other serovar was found in this study. Overall percentage of multidrug resistance for both salmonella typhi and paratyphi was 74(37.5%).
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These data suggest that levofloxacin/imipenem may be an effective combination for preventing the emergence of resistance among P. aeruginosa, even with strains already lacking susceptibility to one or both drugs in the combination. Clinical evaluation of this combination is warranted.
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BsP appears to be a promising candidate as a vehicle for topical ophthalmic drug delivery, especially for antibiotics.
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Carbapenems, linezolid, tigecycline and vancomycin conserved good in vitro activity against most pathogens (according to their spectrum of activity) in France between 2004 and 2012.
Of the 5,002 samples, 3,447 tested positive for cultures (isolation rate: 68.9%). A total of 4,537 strains were isolated. In descending order, the microorganisms isolated were 1,706 strains of coagulase negative Staphylococcus (CNS), including Staphylococcus epidermidis (37.6%), 936 strains of Corynebacterium spp. (20.6%), 635 strains of Staphylococcus aureus (14.0%), 412 strains of Haemophilus influenzae (9.1%), and 246 strains of Streptococcus pneumoniae (5.4%). CNS, Corynebacterium and S. aureus were isolated in relatively large numbers in patients of all ages. H. influenzae and S. pneumoniae were common in children six and under and from winter to spring. At the sametime, resistant bacteria (PRSP or PISP: 166 strains; 2000 onward, BLNAR: 192 strains; and BLPACR: 6 strains) were detected more frequently than sensitive bacteria. H. influenzae was hypersensitive to cefotaxime (CTX) and levofloxacin. Almost no toleration of CTX was observed in S. pneumoniae.
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Korea exhibits the highest rates of multidrug resistance among Streptococcus pneumoniae. The increasing use of levofloxacin has raised concern about the dissemination of levofloxacin resistance in dominant multidrug-resistant (MDR) clones of our pneumococcal population. A total of 50 levofloxacin-nonsusceptible S. pneumoniae (MIC, ≥4 μg/mL) collected from a multihospital network from 1996 to 2006 were analyzed for serotype, antibiotic resistance profile, quinolone resistance-determining region mutation, and multilocus sequence type. Most levofloxacin-nonsusceptible S. pneumoniae (94.0%) exhibited an MDR phenotype. This phenotype was closely associated with a limited number of epidemic MDR clones that are well-known key agents of the global spread of antimicrobial resistance in S. pneumoniae. However, the clonal dissemination of levofloxacin-nonsusceptible S. pneumoniae was rare. Levofloxacin-nonsusceptible clones with nonvaccine serotypes increased during the post-vaccine era in this study. This result suggests that Korean clinicians must be aware of the levofloxacin resistance trend and need to be more prudent for the first choice of fluoroquinolone for empiric treatment of respiratory tract infections in clinical setting. Moreover, the emergence of new clones and their variations may be more frequently associated with resistance under this selective pressure, such as the introduction of a 7-valent pneumococcal conjugate vaccine into our community.