Displaying publications 1 - 20 of 88 in total

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  1. Melioidosis presenting as prostatitis--a case report from Sabah
    Kan SPK, Kay RWW
    Trans R Soc Trop Med Hyg, 1978;72(5):522-4.
    PMID: 725999 DOI: 10.1016/0035-9203(78)90175-X
    Previous reports of melioidosis in Sabah are reviewed and a detailed account of a case, presenting as prostatitis, in a 40-year-old British male is given. The history suggested that the organism, Pseudomonas pseudomallei, was transmitted by a fly which entered the eye. Diagnosis was delayed and treatment presented some difficulty, the organism being relatively insensitive to amplicillin and gentamicin. Co-trimoxazole was the most effective, followed by minocycline. Cure was eventually achieved and after four years the patient was fit and normal, except for sterility.
    Matched MeSH terms: Gentamicins/therapeutic use
  2. Fulltext Monitoring of serum gentamicin level in a general hospital
    Hussin Z, Lim VKE
    Med J Malaysia, 1982 Jun;37(2):104-7.
    PMID: 7132829
    Gentamicin is an aminoglycoside antibiotic which is commonly used in the treatment of serious Gram-negative infections. However, gentamicin like other aminoglycosides, has a narrow therapeutic index and is potentially ototoxic and nephrotoxic. Blood levels following administration of gentamicin has been shown to be highly unpredictable and monitoring of gentamicin levels is necessary to ensure effective therapeutic levels as well as to avoid toxicity. The Department of Microbiology, Universiti Kebangsaan Malaysia offers such a monitoring service. This paper analyses the results of 135 such estimations performed between August 1979 and May 1981. It is shown that a significant proportion of patients were receiving either too much or too little gentamicin. Empirical determinations of dosages is unsatisfactory and as the microbiological assay method of determining gentamicin levels is both easy to perform and inexpensive, such a service should be offered by all general hospitals in Malaysia.
    Matched MeSH terms: Gentamicins/blood*
  3. Fulltext Fulminant hepatic failure and shigella bacteremia
    Abidin Z, Iyngkaran N, Puthucheary SD
    Med J Malaysia, 1983 Jun;38(2):112-3.
    PMID: 6353185
    A three and a half year old boy with shigellosis developed fulminant hepatic failure. The hepatic derangements rapidly improved over a period of two weeks after treatment of the shigellosis with parenteral gentamicin. We believe this is the first documented report of fulminant hepatic failure due to shigella sepsis.
    Matched MeSH terms: Gentamicins/therapeutic use
  4. Clinical pharmacokinetics, toxicity and cost effectiveness analysis of aminoglycosides and aminoglycoside dosing services
    Mathews A, Bailie GR
    J Clin Pharm Ther, 1987 Oct;12(5):273-91.
    PMID: 3119606
    This article reviews the clinical pharmacokinetics, clinical toxicity and cost-effectiveness analysis of aminoglycosides and of dosing services for aminoglycosides. The reader is referred elsewhere for a review of the pharmacology, antimicrobial spectrum of activity and clinical use of these drugs. A critique of the more commonly used methods of aminoglycoside dosage determinations is included, based on the inter-individual variation in aminoglycoside disposition parameters. The advantages and disadvantages of arbitrary, predictive, and pharmacokinetic methods of dosing determination are summarized. Justification for the routine determination of serum aminoglycoside concentrations is reviewed. We review the lack of standardization of definitions for aminoglycoside-associated nephrotoxicity in published studies, and studies which illustrate these differences are highlighted. Evidence for the association between serum aminoglycoside concentrations and nephrotoxicity is examined. Ototoxicity is similarly reviewed. The concept of cost-effectiveness analysis is examined extensively in this review. We discuss the literature concerning the cost benefit analysis of drug dosing services.
    Matched MeSH terms: Gentamicins/administration & dosage; Gentamicins/adverse effects; Gentamicins/pharmacokinetics
  5. Fulltext Therapeutic drug monitoring for gentamicin in Hospital Universiti Sains Malaysia
    Ismail R, Sarriff A, Abdul Rahman AF
    Med J Malaysia, 1990 Mar;45(1):57-64.
    PMID: 2152070
    We evaluated the usefulness of therapeutic drug monitoring (TDM) for gentamicin and the use of a two-point peak and trough pair concentration method to adjust its dose. Of the 194 patients included, initial concentrations were appropriate in only sixty nine. In the seventy one cases of dosage adjustments using this method, those attaining therapeutic levels increased overall from 38% to 67%. It is concluded that TDM for gentamicin with dosage adjustment using this simple pharmacokinetic approach is useful and adequate in monitoring for gentamicin therapy.
    Matched MeSH terms: Gentamicins/administration & dosage*; Gentamicins/blood; Gentamicins/therapeutic use
  6. Management of infective endocarditis in pregnancy
    Jeyamalar R, Sivanesaratnam V
    Aust N Z J Obstet Gynaecol, 1991 May;31(2):123-4.
    PMID: 1930032
    Matched MeSH terms: Gentamicins/administration & dosage; Gentamicins/therapeutic use*
  7. Gentamicin administration via peritoneal dialysis fluid: the risk of ototoxicity
    Gendeh BS, Said H, Gibb AG, Aziz NS, Zahir ZM
    J Laryngol Otol, 1991 Dec;105(12):999-1001.
    PMID: 1787382
    In a prospective study on 47 patients, 16 mg of gentamicin per two litres dialysate was administered intraperitoneally at every cycle of intermittent peritoneal dialysis, carried out over the course of several days. Serum gentamicin sampling, pure tone audiometry and caloric tests were performed before and during the treatment. The gentamicin levels reached at the end of the thirtieth cycle were observed to be low. In view of this, the risk of acute ototoxicity was considered to be minimal. This was confirmed by the absence of clinical audiometric or vestibulometric evidence of toxicity.
    Matched MeSH terms: Gentamicins/administration & dosage; Gentamicins/adverse effects*; Gentamicins/blood; Gentamicins/therapeutic use
  8. Gentamicin ototoxicity in continuous ambulatory peritoneal dialysis
    Gendeh BS, Said H, Gibb AG, Aziz NS, Kong N, Zahir ZM
    J Laryngol Otol, 1993 Aug;107(8):681-5.
    PMID: 8409715 DOI: 10.1017/s0022215100124132
    A prospective study was undertaken of 10 chronic renal failure patients on Continuous Ambulatory Peritoneal Dialysis (CAPD) complicated by repeated bouts of peritonitis treated with gentamicin. Each 10-day treatment course consisted of a 120 mg loading dose, followed by 16 mg in 21 of peritoneal dialysate, given four times a day. Serum gentamicin analysed by enzyme immunoassay showed a mean level of 5.2 micrograms/ml, (range 3.7 to 6.6 mg/ml) four hours after the loading dose. Similar levels, well within the therapeutic range, were maintained on the 3rd, 5th, 7th and 9th days of intraperitoneal gentamicin therapy, suggesting no accumulation of gentamicin in the serum. Pure tone audiometry, electronystagmography and clinical assessment were performed during each course of treatment. Although no evidence of ototoxicity was found during the first two courses of gentamicin, but disequilibrium and bobbing oscillopsia were present during the third and fourth courses of gentamicin. These findings could be explained by cumulative injury to the vestibular apparatus caused by repeated therapeutic insults.
    Matched MeSH terms: Gentamicins/adverse effects*; Gentamicins/blood; Gentamicins/therapeutic use
  9. An outbreak of methicillin resistant Staphylococcus aureus in the neonatal intensive care unit - Seremban Hospital
    Musa Mohd Nordin, Wong, Swee Lan
    Malaysian Journal of Child Health, 1993;5(1):26-30.
    MyJurnal
    An outbreak of Methicillin Resistant Staphylococcus aureus (MRSA) in the Neonatal Intensive Care Unit (NICU), Seremban Hospital is reported. The pattern of colonisation and infection with the MRSA was studied for the 1 year period between May 1987 till April 1988. There were few serious MRSA infections. The majority of patients were either colonised or superficially infected. The organism was resistant to all Penicillins, Gentamicin and most Cephalosporins. Netilmicin and Amikacin have shown good activity against MRSA.
    Matched MeSH terms: Gentamicins
  10. Fulltext Topical chloramphenicol/gentamicin in the empirical treatment of acute conjunctivitis--is it rational?
    Subramania A, Reddy SC
    Med J Malaysia, 1996 Dec;51(4):491.
    PMID: 10968042
    Matched MeSH terms: Gentamicins/therapeutic use*
  11. 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: Gentamicins/administration & dosage; Gentamicins/adverse effects; Gentamicins/blood; Gentamicins/therapeutic use*
  12. Antibiotic resistance and plasmid profile of Aeromonas hydrophila isolates from cultured fish, Telapia (Telapia mossambica)
    Son R, Rusul G, Sahilah AM, Zainuri A, Raha AR, Salmah I
    Lett Appl Microbiol, 1997 Jun;24(6):479-82.
    PMID: 9203404
    Strains of Aeromonas hydrophila isolates from skin lesions of the common freshwater fish, Telapia mossambica, were screened for the presence of plasmid DNA by agarose gel electrophoresis and tested for susceptibility to 10 antimicrobial agents. Of the 21 fish isolates examined, all were resistant to ampicillin and sensitive to gentamycin. Most isolates were resistant to streptomycin (57%), tetracycline (48%) and erythromycin (43%). While seven of 21 isolates harboured plasmids, with sizes ranging from 3 to 63.4 kilobase pair (kb), it was only possible to associate the presence of a plasmid with antibiotic resistance (ampicillin and tetracycline) in strain AH11. Both the plasmid and the associated antimicrobial resistance could be transferred to an Escherichia coli recipient by single-step conjugation at a frequency of 4.3 x 10(-3) transconjugants per donor cell.
    Matched MeSH terms: Gentamicins/pharmacology
  13. Effect of gestational age on gentamicin pharmacokinetic parameters in the newborn
    Farizaturradiah O, Mohamed Z, Sim SM, Lim CT
    JUMMEC, 1997;2:35-38.
    Matched MeSH terms: Gentamicins
  14. Vestibular nerve section in a child with intractable Menière's disease
    See GB, Mahmud MR, Zurin AA, Putra SH, Saim LB
    Int J Pediatr Otorhinolaryngol, 2002 May 31;64(1):61-4.
    PMID: 12020915
    Clinical presentation of Menière's disease in children is not as typical as in adults. The triad of vertigo, tinnitus and deafness are not usually elicited, diagnosis often being made after years of follow up and batteries of investigation. A case of Menière's disease in a 3-year-old boy is presented. The diagnosis was only obvious at the age of 8 when the triad of vertigo, deafness and tinnitus were present. His disease progressed despite a trial of intratympanic gentamicin injections and endolymphatic sac decompression. Vestibular nerve section was subsequently performed for his intractable disease. Following the procedure he was asymptomatic and able to attend school.
    Matched MeSH terms: Gentamicins/pharmacology
  15. A clinical and economic study of community-acquired pneumonia between single versus combination therapy
    Hasali MA, Ibrahim MI, Sulaiman SA, Ahmad Z, Hasali JB
    Pharm World Sci, 2005 Jun;27(3):249-53.
    PMID: 16096896
    BACKGROUND: Pneumonia is one of the leading causes of morbidity and mortality among children in many developing countries. It is reported that 12.9 million children under 5 years of age died world-wide in 1990 and one-third of these deaths or 4.3 million annually were attributed to acute respiratory infection with pneumonia.

    OBJECTIVES: On this basis, a study was conducted in a district hospital to study the therapy outcomes of antibiotic regimens used in pediatric community-acquired pneumonia (CAP) management and to conduct a cost-effectiveness analysis (CE) between IV ampicillin versus combination therapy of IV ampicillin and IV gentamicin.

    METHOD: A prospective, randomized, controlled, single blind study was conducted in a pediatric ward in a 80-bed district hospital. Pediatric patients diagnosed with CAP aged 2 months to 5 years old were randomly and equally divided into two treatment arms: ampicillin versus ampicillin plus gentamicin. The dose of IV ampicillin used in this study was 100 mg/kg/day divided every 6 h and 5 mg/kg of IV gentamicin as a single daily dose. Both clinical and economic evaluations were carried out to compare both treatment arms.

    RESULTS: With the inclusion and exclusion criteria, only 40 patients diagnosed with CAP were included in the study. The results showed that the two treatment arms were significantly different (P < 0.05) in terms of duration of patients on ampicillin, number of days of hospitalization and time to switch to oral therapy. A significant difference was noted between the two treatment modalities in terms of effectiveness and cost (P < 0.05).

    CONCLUSION: Overall, the endpoint of this study showed that the total cost per patient of ampicillin-treated group is cheaper than the total cost with the combination therapy (ampicillin plus gentamicin) and reduced unnecessary exposure to adverse effects or toxicities. Besides that, addition of gentamicin in the treatment modalities will only increase the cost of treatment without introducing any changes in the treatment outcome.

    Matched MeSH terms: Gentamicins/economics; Gentamicins/therapeutic use
  16. Role of glucocorticoids in ototopical antibiotic-steroid preparations in the treatment of chronic suppurative otitis media
    Indudharan R, Valuyeetham KA, Raju SS
    Arch Med Res, 2005 Mar-Apr;36(2):154-8.
    PMID: 15847949 DOI: 10.1016/j.arcmed.2004.12.012
    It is conventional to use antibiotic-steroid combination eardrops, although the advantage of steroid combination has not been substantiated. The present prospective randomized comparative study is designed to assess the role of glucocorticoids in ototopical antibiotic-steroid preparations in the treatment of chronic suppurative otitis media (CSOM).
    Matched MeSH terms: Gentamicins/therapeutic use*
  17. 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: Gentamicins/administration & dosage; Gentamicins/blood; Gentamicins/therapeutic use*
  18. 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: Gentamicins/administration & dosage; Gentamicins/therapeutic use*
  19. Fulltext Pseudomonas aeruginosa: epidemiology of bactereremia and antimicrobial susceptibility pattern in a teaching hospital in Kuala Lumpur
    Nadeem, S.R., Rina, K., Hamimah, H., Savithri, D.P.
    JUMMEC, 2006;9(1):14-19.
    MyJurnal
    A cross-sectional study of 109 patients with Pseudomonas aeruginosa bacteremia from the University of Malaya Medical Centre (UMMC) in the years 2000 and 2001 was conducted to describe epidemiological features, underlying diseases, possible source of infection, early mortality among patients as well as the antibiotic susceptibility pattern of patients' isolates. Further analysis of the 87 patient records that were available revealed that the mean age was 48.5 years (SD ± 25.1). Fifty-two per cent of cases were male and 48% female. Seventy-nine per cent of infections were nosocomially acquired, 33% of bacteremias were polymicrobial, 47% of patients had a continuous bladder drainage catheter (CBD) in situ, 33% had a central venous catheter (CVL) present at the time of bacteremia and 30% were ventilated. Sixty-eight per cent of patients had an underlying immunosuppressed state and 26% had undergone surgery involving general anesthesia in the week prior to isolating P. aeruginosa. Among the 23 patients with early mortality, 61% were on inappropriate antimicrobials. Most of the patients' isolates were sensitive to imipenem (86%), ciprofloxacin (81%), ceftazidime (79%), gentamicin (78%) and cefoperazone (77%). Among the community acquired strains, however, there was 100% sensitivity to imipenem, ceftazidime, cefoperazone and ciprofloxacin.
    Matched MeSH terms: Gentamicins
  20. A nanoplex PCR assay for the rapid detection of vancomycin and bifunctional aminoglycoside resistance genes in Enterococcus species
    Yean CY, Yin LS, Lalitha P, Ravichandran M
    BMC Microbiol, 2007 Dec 11;7:112.
    PMID: 18070365
    BACKGROUND: Enterococci have emerged as a significant cause of nosocomial infections in many parts of the world over the last decade. The most common enterococci strains present in clinical isolates are E. faecalis and E. faecium which have acquired resistant to either gentamicin or vancomycin. The conventional culture test takes 2-5 days to yield complete information of the organism and its antibiotic sensitivity pattern. Hence our present study was focused on developing a nanoplex PCR assay for the rapid detection of vancomycin and bifunctional aminoglycoside resistant enterococci (V-BiA-RE). This assay simultaneously detects 8 genes namely 16S rRNA of Enterococcus genus, ddl of E. faecalis and E. faecium, aacA-aphD that encodes high level gentamicin resistance (HLGR), multilevel vancomycin resistant genotypes such as vanA, vanB, vanC and vanD and one internal control gene.

    RESULTS: Unique and specific primer pairs were designed to amplify the 8 genes. The specificity of the primers was confirmed by DNA sequencing of the nanoplex PCR products and BLAST analysis. The sensitivity and specificity of V-BiA-RE nanoplex PCR assay was evaluated against the conventional culture method. The analytical sensitivity of the assay was found to be 1 ng at the DNA level while the analytical specificity was evaluated with 43 reference enterococci and non-enterococcal strains and was found to be 100%. The diagnostic accuracy was determined using 159 clinical specimens, which showed that 97% of the clinical isolates belonged to E. faecalis, of which 26% showed the HLGR genotype, but none were vancomycin resistant. The presence of an internal control in the V-BiA-RE nanoplex PCR assay helped us to rule out false negative cases.

    CONCLUSION: The nanoplex PCR assay is robust and can give results within 4 hours about the 8 genes that are essential for the identification of the most common Enterococcus spp. and their antibiotic sensitivity pattern. The PCR assay developed in this study can be used as an effective surveillance tool to study the prevalence of enterococci and their antibiotic resistance pattern in hospitals and farm animals.

    Matched MeSH terms: Gentamicins/pharmacology
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