Displaying publications 1 - 20 of 129 in total

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  1. The place of Bactrim and Vibramycin in acute salpingitis
    Ng A
    Med J Malaysia, 1975 Dec;30(2):133-4.
    PMID: 1241709
    Matched MeSH terms: Anti-Bacterial Agents/administration & dosage*
  2. Comprehension of antibiotic instructions in an outpatient Malaysian practice
    Hassan Y, Abd Aziz N, Sarriff A, Darwis Y, Ibrahim P
    Hosp Pharm, 1994 Jan;29(1):48-50, 53.
    PMID: 10131493
    Patients may not comply with antibiotic instructions because they do not understand them. The aim of this study was to assess outpatients' ability to comprehend their antibiotic prescription labels. Two hundred and five subjects on oral antibiotic regimens from an outpatient clinic and pharmacy of a district hospital were selected in this survey. All patients were interviewed by trained clinical pharmacy students. They were asked to read the labels and then how they would take their antibiotics. The results show that 119 (58.1%) patients could interpret the label. Forty-nine (23.9%) patients knew the name of antibiotics and interpreted the directions of use correctly. One hundred sixteen (56.6%) subjects were able to recall the auxiliary information. However, only 44 (21.4%) patients were able to comprehend complete antibiotic instruction. This study demonstrates that a significant proportion of patients could not interpret the labeling instruction. The comprehension level of patients was low and significantly associated (P < 0.05) with the ability of patient to read the label contents. These observations illustrate the need for physicians and pharmacists to provide antibiotic instructions and review these instructions with the patient.

    Study site: outpatient clinic and pharmacy of a district hospita
    Matched MeSH terms: Anti-Bacterial Agents/administration & dosage*
  3. Therapeutic drug monitoring of gentamicin: a 6-year follow-up audit
    Ismail R, Haq AH, Azman M, Rahman AF
    J Clin Pharm Ther, 1997 Feb;22(1):21-5.
    PMID: 9292398
    In 1984 a therapeutic drug monitoring (TDM) service was established in Hospital Universiti Sains Malaysia (HUSM) and gentamicin concentrations were measured and used to design optimal regimens for the antibiotic. In this study we report on a 6-year follow-up audit since our first assessment of the service.
    Matched MeSH terms: Anti-Bacterial Agents/administration & dosage
  4. Longevity of antibody responses to a Salmonella typhi-specific outer membrane protein: interpretation of a dot enzyme immunosorbent assay in an area of high typhoid fever endemicity
    Choo KE, Davis TM, Ismail A, Ong KH
    Am J Trop Med Hyg, 1997 Dec;57(6):656-9.
    PMID: 9430522
    The objective of this study was to investigate the longevity of positive dot enzyme immunosorbent assay (dot EIA) results for IgM and IgG to a Salmonella typhi outer membrane protein in Malaysian children with enteric fever. The patients were children one month to 12 years of age with clinical evidence of typhoid fever, positive blood or stool cultures for S. typhi, and/or a positive Widal test result who were admitted over a two-year period to General Hospital (Kota Bharu, Malaysia). These patients received standard inpatient treatment for enteric fever including chloramphenicol therapy for 14 days. Dot EIA tests were performed as part of clinical and laboratory assessments on admission, at two weeks, and then at 3, 6, 9, 12, 15, 18, and 21 months postdischarge. Assessment of the longevity of positive dot EIA IgM and IgG titers was done by Kaplan-Meier analysis. In 94 evaluable patients, 28% were dot EIA IgM positive but IgG negative on admission, 50% were both IgM and IgG positive, and 22% were IgM negative and IgG positive. Mean persistence of IgM dot EIA positivity was 2.6 months (95% confidence interval = 2.0-3.1 months) and that of IgG was 5.4 months (4.5-6.3 months). There were no significant differences between the three subgroups. Thus, positive IgM and IgG results determined by dot EIA within four and seven months, respectively, following documented or suspected enteric fever in a child from an endemic area should be interpreted with caution. In other clinical situations, the dot EIA remains a rapid and reliable aid to diagnosis.
    Matched MeSH terms: Anti-Bacterial Agents/administration & dosage
  5. Vancomycin administration in continuous ambulatory peritoneal dialysis: the risk of ototoxicity
    Gendeh BS, Gibb AG, Aziz NS, Kong N, Zahir ZM
    Otolaryngol Head Neck Surg, 1998 Apr;118(4):551-8.
    PMID: 9560111
    A prospective study was undertaken in 16 patients with chronic renal failure on continuous ambulatory peritoneal dialysis, with 22 episodes of peritonitis treated with vancomycin, a known ototoxic agent. Twelve patients had one episode each, and four had recurrent peritonitis. Each treatment course consisted of two infusions of vancomycin (30 mg/kg body weight) in 2 L of peritoneal dialysate administered at 6-day intervals. Serum vancomycin analyzed by enzyme immunoassay showed a mean trough level of 11.00 microg/ml on day 6 and mean serum levels of 33.8 and 38.6 microg/ml about 12 hours after administration on days 1 and 7, respectively. Similar levels, well within the therapeutic range, were encountered with repeated vancomycin therapy for recurrent episodes of peritonitis, suggesting that no changes occurred in the pharmacokinetic profile of the drug. Pure-tone audiometry, electronystagmography, and clinical assessment performed during each course of treatment showed no evidence of ototoxicity even on repeated courses of vancomycin therapy. The results suggest that vancomycin therapy when given in appropriate concentrations as a single therapeutic agent is both effective and safe. We believe, however, that vancomycin administered in combination with an aminoglycoside may produce ototoxic effects that may be greatly aggravated, possibly because of synergism.
    Matched MeSH terms: Anti-Bacterial Agents/administration & dosage
  6. Fulltext Current trends in the management of chronic obstructive pulmonary disease
    Liam CK
    Med J Malaysia, 2000 Jun;55(2):285-92; quiz 293.
    PMID: 19839165
    Matched MeSH terms: Anti-Bacterial Agents/administration & dosage
  7. Red man syndrome during administration of prophylactic antibiotic against infective endocarditis
    Ngeow WC, Chai WL, Moody AB
    J Ir Dent Assoc, 2000;46(3):92-4.
    PMID: 11323942
    Red man syndrome (RMS) is the occurrence flushing, pruritus, chest pain, muscle spasm or hypotension during vancomycin infusion. It usually happens as a result of rapid infusion of the drug but may also occur after slow administration. The frequency and severity of this phenomenon diminish with repeated administration of vancomycin. A case is presented whereby RMS occurred while prophylactic antibiotic against infective endocarditis was administered.
    Matched MeSH terms: Anti-Bacterial Agents/administration & dosage
  8. Single-daily ceftriaxone plus amikacin versus thrice-daily ceftazidime plus amikacin as empirical treatment of febrile neutropenia in children with cancer
    Ariffin H, Arasu A, Mahfuzah M, Ariffin WA, Chan LL, Lin HP
    J Paediatr Child Health, 2001 Feb;37(1):38-43.
    PMID: 11168867
    OBJECTIVE: Empirical antibiotic treatment for febrile neutropenic patients has been the mainstay of treatment for many years. Beta-lactam antibiotics and aminoglycosides have been the most frequently used drug combination. The purpose of this study was to evaluate the efficacy, safety, tolerance and costs of single-daily ceftriaxone plus amikacin versus thrice-daily dose of ceftazidime plus amikacin.

    METHODOLOGY: One hundred and ninety-one episodes of fever and neutropenia in 128 patients from October 1997 to December 1998 were included in a prospective, open-label, single-centre study. Patients were randomly assigned to either treatment group and evaluated as successes or failures according to defined criteria. Daily assessments were made on all patients and all adverse events recorded. Univariate and multivariate analysis of outcomes and a cost analysis were carried out.

    RESULTS: There were 176 evaluable patient-episodes with 51.1% in the single-daily ceftriaxone-amikacin group and 48.9% in the ceftazidime-amikacin group. There were 50 positive blood cultures: 12 Gram-positive bacteria, 33 Gram-negative bacteria and five fungi. Pseudomonas aeruginosa (P. aeruginosa) accounted for 14% of total isolates. The overall success rate was 55.5% in the ceftriaxone group compared to 51.2% in the ceftazidime group (P = 0.56). Mean time to defervescence was 4.2 days in the single-daily group and 4.3 days in the thrice-daily group. There were nine infection-related deaths; five in the single-daily ceftriaxone group. The daily cost of the once-daily regime was 42 Malaysian Ringgit less than the thrice-daily regime. There was a low incidence of adverse effects in both groups, although ototoxicity was not evaluable.

    CONCLUSIONS: The once-daily regime of ceftriaxone plus amikacin was as effective as the 'standard' combination of thrice-daily ceftazidime and amikacin with no significant adverse effects in either group. The convenience and substantial cost benefit of the once-daily regime will be particularly useful in developing countries with limited health resources and in centres with a low prevalence of P. aeruginosa.

    Matched MeSH terms: Anti-Bacterial Agents/administration & dosage*
  9. Fulltext Reevaluating the use of antibiotics in acute otitis media in children
    Elango S
    Med J Malaysia, 2003 Aug;58(3):465-9.
    PMID: 14750393
    Increasing concern about the antibiotic resistance in acute otitis media (AOM) has led to debate over use of antibiotic in AOM and duration of therapy. Many studies have proved that watchful waiting should be used more often for acute otitis media. In children over two years, the most appropriate treatment was found to be initial observation followed by 5 days of an antibiotic if the child failed to improve spontaneously. In children less than 2 years or one with severe symptoms antibiotic can be started after 24 hours if there is no improvement with symptomatic treatment. Physician should be more selective in the prescription of antibiotics early in AOM.
    Matched MeSH terms: Anti-Bacterial Agents/administration & dosage*
  10. Potent antibacterial activity of halogenated compounds against antibiotic-resistant bacteria
    Vairappan CS, Kawamoto T, Miwa H, Suzuki M
    Planta Med, 2004 Nov;70(11):1087-90.
    PMID: 15549668
    Common Gram-positive clinical pathogens are showing an increasing trend for resistance to conventional antimicrobial agents. New drugs with potent antibacterial activities are urgently needed to remediate this problem. Halogenated compounds isolated from several species of the red algae genus Laurencia were examined for their antibacterial activity against 22 strains of human pathogenic bacteria, 7 strains of which were antibiotic-resistant bacteria. Four phenolic sesquiterpenes and a polybrominated indole showed wide spectra of antibacterial activity against Gram-positive bacteria including methicillin-resistant Staphylococcus aureus (MRSA), penicillin-resistant Streptococcus pneumoniae, and vancomycin-resistant Enterococcus faecalis and E. faecium (VRE). In addition, laurinterol and allolaurinterol displayed potent bactericidal activity against three strains of MRSA at 3.13 microg mL(-1), and three strains of vancomycin-susceptible Enterococcus, at 3.13 microg mL(-1) and 6.25 microg mL(-1), respectively.
    Matched MeSH terms: Anti-Bacterial Agents/administration & dosage
  11. Case report post-splenectomy sepsis in thalassemic patients
    Zarina AL, Hamidah A, Zulkifli SZ, Jamal R
    Southeast Asian J. Trop. Med. Public Health, 2005 Mar;36(2):471-3.
    PMID: 15916058
    Thalassemia is the commonest hemoglobinopathy in Malaysia. Patients with thalassemia major are transfusion dependent, and a large proportion of them will require splenectomy. As this particular group of patients is immunocompromized, overwhelming sepsis is a recognized complication. We report a series of three patients who all developed intra-abdominal abscesses following splenectomy.
    Matched MeSH terms: Anti-Bacterial Agents/administration & dosage
  12. Providing guidelines and education is not enough: an audit of gentamicin use at The Royal Melbourne Hospital
    Leong CL, Buising K, Richards M, Robertson M, Street A
    Intern Med J, 2006 Jan;36(1):37-42.
    PMID: 16409311
    BACKGROUND: Aminoglycoside antibiotics are commonly prescribed for the treatment of Gram-negative infections. Appropriate dosing and therapeutic monitoring of aminoglycosides are important because these agents have a narrow therapeutic index.
    AIM: To audit gentamicin use at our hospital, focusing on selection of the initial dose and therapeutic monitoring practices, and to compare the results against recommendations in the existing hospital aminoglycoside guidelines, which had recently been promoted to doctors.
    METHODS: This audit included all inpatients receiving gentamicin at The Royal Melbourne Hospital from 1 February to 12 March 2004. The principal researcher checked the drug charts of all inpatients to identify those receiving gentamicin and collected data from the medical records and the pathology database. Doses were considered 'concordant' if the dose given was within the recommended dosing range +/-20 mg.
    RESULTS: A total of 132 courses of gentamicin was included in the study. Gentamicin was prescribed for prophylaxis in 31.1% of courses. Thirty-six per cent of patients prescribed gentamicin were more than 65 years of age. Eighty-two per cent of the gentamicin used therapeutically was given as a single daily dose. Sixty-six per cent of gentamicin initial dosing was not in accordance with existing hospital guidelines. Seventy-seven per cent of gentamicin courses requiring therapeutic drug monitoring received such monitoring; however, in only 8.8% of these was the monitoring conducted according to guidelines.
    CONCLUSION: Aminoglycoside prescribing practices at our hospital are suboptimal, despite ready access to prescribing guidelines. Provision of a guideline and education sessions with doctors do not necessarily lead to widespread adoption of recommended practices. We suggest that changes to hospital systems related to prescribing and monitoring of aminoglycosides are required.
    Matched MeSH terms: Anti-Bacterial Agents/administration & dosage
  13. Fulltext Melioidotic osteomyelitis treated with antibiotic-calcium hydroxyapatite composite: case report with four-year follow-up
    Ng WM, Kwan MK, Merican AM
    Singapore Med J, 2006 Jan;47(1):71-4.
    PMID: 16397726
    Melioidosis is caused by an infection by Burkholderia pseudomallei. Osteomyelitis is a recognised manifestation of melioidosis but Burkholderia pseudomallei is a relatively rare aetiological agent in musculoskeletal infections. We report a 32-year-old diabetic man with septicaemia due to melioidotic infection of the spleen, liver and distal femur. The osteomyelitis relapsed despite being treated with the standard radical debridement and insertion of gentamycinimpregnated polymethylmetacrylate (PMMA) beads, followed by an optimal antibiotic therapy. The PMMA-gentamycin beads were then removed. The bone defect was debrided and packed with calcium hydroxyapatite blocks filled with ceftazidime powder. The osteomyelitis was successfully treated and the patient remained free of infection four years postoperatively. Computed tomography demonstrated successful incorporation of the calcium hydroxyapatite into host bone.
    Matched MeSH terms: Anti-Bacterial Agents/administration & dosage*
  14. Fulltext Antimicrobial properties of erythromycin and colistin impregnated bone cement. An in vitro analysis
    Ruzaimi MY, Shahril Y, Masbah O, Salasawati H
    Med J Malaysia, 2006 Feb;61 Suppl A:21-6.
    PMID: 17042224
    Deep surgical site infection is a devastating consequence of total joint arthroplasty. The use of antibiotic impregnated bone cement is a well-accepted adjunct for treatment of established infection and prevention of deep orthopaedic infection. It allows local delivery of the antibiotic at the cement-bone interface and sustained release of antibiotic provides adequate antibiotic coverage after the wound closure. Preclinical testing, randomised and clinical trials indicate that the use of antibiotic-impregnated bone cement is a potentially effective strategy in reducing the risk of deep surgical site infection following total joint arthroplasty. The purpose of this study was to assess antibacterial activity of erythromycin and colistin impregnated bone cement against strains of organisms' representative of orthopaedic infections including Gram-positive and Gram-negative aerobic organisms: Staphylococcus aureus, coagulase-negative Staphylococci, Enterococcus sp., Proteus sp., Klebsiella sp., Pseudomonas sp., and Escherichia coli. Pre-blended Simplex P bone cement with the addition of erythromycin and colistin (Howemedica Inc) was mixed thoroughly with 20ml liquid under sterile conditions to produce uniform cylindrical discs with a diameter of 14mm and thickness of 2mm. 24-48 hour agar cultures of Staphylococcus aureus, coagulase-negative Staphylococci, Enterococcus sp.,Proteus sp., Klebsiella sp.,Pseudomonas sp., and Escherichia coli were used for the agar diffusion tests. The agar plates were streaked for confluent growth followed by application of erythromycin and colistin impregnated bone cement disc to each agar plate. The plates were incubated at 30 degrees C and examined at 24, 48, 72 hours, and four and five days after the preparation of the impregnated cement. The susceptibility of Staphylococcus aureus to the control discs was most clearly demonstrated showing a distinct zone of inhibition. The zone observed around coagulase-negative Staphylococci, Klebsiella sp., Pseudomonas sp., and Escherichia coli were also significant. However, there was no zone of inhibition or signs of antibacterial activity at the cemented surface were detected around discs with Enterococcus sp. and Proteus sp. The results showed that Simplex P bone cement with the addition of erythromycin and colistin was effective against most of the broad spectrum organisms encountered during total joint arthroplasty. The activity of Simplex P bone cement impregnated with erythromycin and colistin is mainly during the first 72 hours.
    Matched MeSH terms: Anti-Bacterial Agents/administration & dosage
  15. Fulltext Biomechanical properties of bone cement with addition of cefuroxime antibiotic
    Mohd Fuad D, Masbah O, Shahril Y, Jamari S, Norhamdan MY, Sahrim SH
    Med J Malaysia, 2006 Feb;61 Suppl A:27-9.
    PMID: 17042225
    Antibiotic-loaded bone cement has been used as prophylaxis against infection in total joint replacement surgery. Its effect on the mechanical strength of cement is a major concern as high dose of antibiotic was associated with a significant reduction in mechanical strength of bone cement. However, the cut-off antibiotic that weakens the mechanical strength of cement remains to be determined. This study was undertaken to observe the changes in the mechanical properties of bone cement with gradual increments of Cefuroxime antibiotic. Cefuroxime at different doses: 0, 1.5, 3.0 and 4.5gm were added to a packet of 40gm bone cement (Simplex P) and study samples were prepared by using third generation cementing technique. Mechanical impact, flexural and tensile strength were tested on each sample. Significant impact and tensile strength reduction were observed after addition of 4.5 gm of Cefuroxime. However, flexural strength was significantly reduced at a lower dose of 3.0 gm. The maximum dose of Cefuroxime to be safely added to 40mg Surgical Simplex P is 1.5gm when third generation cementing technique is used. Further study is needed to determine whether it is an effective dose as regards to microbiological parameters.
    Matched MeSH terms: Anti-Bacterial Agents/administration & dosage
  16. Enhanced oral bioavailability and intestinal lymphatic transport of a hydrophilic drug using liposomes
    Ling SS, Magosso E, Khan NA, Yuen KH, Barker SA
    Drug Dev Ind Pharm, 2006 Mar;32(3):335-45.
    PMID: 16556538
    A liposome system was evaluated for oral delivery of a poorly bioavailable hydrophilic drug. The system was prepared from proliposome, which consisted of negatively charged phosphatidylcholine, whereas cefotaxime was chosen as the model drug. An in vivo study was carried out on nine rats according to a three-way crossover design to compare the oral bioavailability of cefotaxime from the liposomal formulation with that of an aqueous drug solution and a physical mixture of cefotaxime with blank liposomes. The results indicated that the extent of bioavailability of cefotaxime was increased approximately 2.7 and 2.3 times compared with that of the aqueous solution and the physical mixture, respectively. In a separate study, simultaneous determination of cefotaxime in intestinal lymph (collected from the mesenteric lymph duct) and in plasma (collected from the tail vein) revealed that its concentration was consistently higher in the lymph than in the plasma when administered via the liposomal formulation, whereas the reverse was observed with the aqueous solution. Thus, the results indicated that the liposomes system has the potential of increasing the oral bioavailability of poorly bioavailable hydrophilic drugs and also promote their lymphatic transport in the intestinal lymph.
    Matched MeSH terms: Anti-Bacterial Agents/administration & dosage
  17. Unrecognised infection in a cystic fibrosis patient
    Asiah K, Hanifah YA, Norzila MZ, Hasniah L, Rusanida A
    J Paediatr Child Health, 2006 Apr;42(4):217-8.
    PMID: 16630326
    We report a 17-year-old Malay boy with cystic fibrosis who over a 14-month period experienced worsening respiratory symptoms and deteriorating lung function. Burkholderia pseudomallei was eventually isolated from his sputum. He improved clinically following treatment for meliodosis and his lung function returned to normal.
    Matched MeSH terms: Anti-Bacterial Agents/administration & dosage
  18. Fulltext Modifying antibiotic prescribing: the effectiveness of academic detailing plus information leaflet in a Malaysian primary care setting
    Teng CL, Achike FI, Phua KL, Nurjahan MI, Mastura I, Asiah HN, et al.
    Med J Malaysia, 2006 Aug;61(3):323-31.
    PMID: 17240584
    We assessed the effectiveness of an educational intervention in reducing antibiotic prescribing in public primary care clinics in Malaysia. Twenty-nine medical officers in nine clinics received an educational intervention consisting of academic detailing from the resident Family Medicine Specialist, as well as an information leaflet. The antibiotic prescribing rates were assessed for six months - three months before and three months after the intervention. A total of 28,562 prescriptions were analyzed. Among participating doctors, general antibiotic prescribing rates for pre- and post-intervention phases were 14.3% and 11.0% (post-intervention vs pre-intervention RR 0.77, 95% CI 0.72 to 0.83). The URTI-specific antibiotic prescribing rates for pre- and post-intervention phases were 27.7% and 16.6%, respectively (post-intervention vs pre-intervention RR 0.60, 95% CI 0.54 to 0.66). No significant change in antibiotic prescribing rates was observed among primary care practitioners who did not participate in the study. This low cost educational intervention using both active and passive strategies focusing on URTI produced a statistically significant (and clinically important) reduction in antibiotic prescribing.
    Study site: Klinik Kesihatan, Negeri Sembilan, Malaysia
    Matched MeSH terms: Anti-Bacterial Agents/administration & dosage*
  19. Fulltext Use of gentamicin impregnated POP discs for antibiotic pouch dressing
    Lau CP, Chee EK, Thirumal M
    Med J Malaysia, 2006 Dec;61 Suppl B:32-6.
    PMID: 17600990
    Antibiotic pouch technique is commonly used due to the high local antibiotic concentration and moist environment for wound healing. We used locally made gentamicin impregnated Plaster of Paris discs in treating wounds with exposed deep structures like tendons and bones. Out of 22 patients treated with this method, 19 completed treatment. Granulation tissue formed quickly and effectively covered the exposed structures. All wounds either healed by secondary intention or became suitable for split skin grafting. Gentamicin impregnated Plaster of Paris disc pouch dressing is safe, cost saving, and effective for management of deep open wounds.
    Matched MeSH terms: Anti-Bacterial Agents/administration & dosage
  20. Fulltext Melioidotic septic arthritis: a case report and literature review
    Raja NS
    J Microbiol Immunol Infect, 2007 Apr;40(2):178-82.
    PMID: 17446969
    Burkholderia pseudomallei, the causative agent of melioidosis, is endemic in southeast Asia and northern Australia. In recent years, the incidence of melioidosis has increased worldwide. Septic arthritis is a rare but well-recognized manifestation of melioidosis. Patients with underlying medical conditions, such as diabetes mellitus, renal impairment, cirrhosis, and malignancy are at greater risk. The presentations of melioidotic septic arthritis often mimic other disease processes and patients may not always be clinically septic. We present a case of septic arthritis due to B. pseudomallei in a 66-year-old male with diabetes mellitus presenting with a history of fever and ankle swelling. Follow-up ankle X-ray showed soft tissue swelling. Synovial fluid and blood samples grew B. pseudomallei. The patient improved gradually after parenteral administration of ceftazidime (2 g 8-hourly) and cotrimoxazole (1440 mg 8-hourly). He was discharged on oral cotrimoxazole (1440 mg 12-hourly), doxycycline (100 mg 12-hourly), and chloramphenicol (500 mg 6-hourly) for 6 months. This case highlights the possible occurrence of melioidotic septic arthritis, and the importance of prompt initiation of appropriate antimicrobials to achieve good outcomes.
    Study site: Emergency department, University of Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Anti-Bacterial Agents/administration & dosage
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