MyMedR

Displaying publications 761 - 780 of 2185 in total

Abstract:

Sort:

Update on the management of Helicobacter pylori infection, including drug-resistant organisms

Goh KL

J Gastroenterol Hepatol, 2002 Apr;17(4):482-7.
PMID: 11982731

Helicobacter pylori infection has many different clinical outcomes. Not all infected persons need to be treated. Therefore, indications for treatment have to be clear, and several consensus guidelines have been formulated to aid the medical practitioner in this decision-making process. Triple therapy with a proton pump inhibitor (PPI), in combination with amoxicillin and clarithromycin is the established treatment of choice. For patients with penicillin hypersensitivity, metronidazole can be substituted for amoxicillin. Bacterial resistance to antibiotics is a major factor adversely affecting treatment success. Resistance to metronidazole has been reported in up to 80%, and resistance to clarithromycin in 2-10% of strains cultured. Resistance to either one of the antibiotics has been reported to result in a drop in efficacy of up to 50%. Emergence of resistance to both metronidazole and clarithromycin following failed therapy is a cause for concern; this underlines the need to use the best available first-line therapy. To avoid the emergence of resistance to both key antibiotics, the combination of metronidazole and clarithromycin should be avoided where possible. For failed treatment, several strategies can be employed. These include ensuring better compliance with repeat therapy, and maximizing the efficacy of repeat treatment by increasing dosage and duration of treatment, as well as altering the choice of drugs. Quadruple therapy incorporating a bismuth compound with a PPI, tetracycline and metronidazole has been a popular choice as a "rescue" therapy. Ranitidine bismuth citrate has been shown to be able to overcome metronidazole and clarithromycin resistance; it may be a useful compound drug to use in place of a PPI in "rescue" therapies. In the case of persistent treatment failures, it is useful to consider repeating gastroscopy and obtaining tissue for culture, and then prescribe antibiotics according to bacterial susceptibility patterns. It is also important in refractory cases to review the original indication for treatment and determine the importance of the indication.

Matched MeSH terms: Anti-Bacterial Agents/therapeutic use*
Empyema thoracis in hospitalized children in Kelantan, Malaysia

Maziah W, Choo KE, Ray JG, Ariffin WA

J Trop Pediatr, 1995 06;41(3):185-8.
PMID: 7636941 DOI: 10.1093/tropej/41.3.185

In this study, 31 cases of childhood empyema thoracis admitted over 4 1/2 years to the Hospital Universiti Sains Malaysia, in Kelantan, Malaysia, were retrospectively reviewed. Twenty-two males and nine females were included, with a mean age of 1.9 years (range: 26 days to 7 years). Frequent symptoms were fever, cough, and dyspnoea, while common signs were temperature above 38 degrees C, decreased breath sounds, dullness to chest percussion, and intercostal recession. Radiography demonstrated unilateral moderate to large effusions in 68 per cent of cases, while consolidated lung was seen in 45 per cent of patients. Pleural fluid cultures were positive for Staphylococcus aureus (48 per cent), Streptococcus pneumoniae (7 per cent), while no growth was seen in 42 per cent of cases. Ninety-four per cent of children had a blood leukocytosis above 10 000 cell/mm3, but blood cultures were negative in 21 out of 26 patients (81 per cent). Most cases were treated with a combination of intravenous antibiotics and chest tube drainage. Antibiotics and pleural tap(s) were used in the remainder. Patients stayed in hospital for an average of 20.7 days (range: 4-52 days). Surgical intervention was necessary in only four children. The mortality rate at the time of discharge was zero, with 100 per cent radiographic resolution among the 23 patients who were followed-up.

Matched MeSH terms: Anti-Bacterial Agents/therapeutic use
Occurrence of Vibrio cholerae 01 strains in Southeast Asia resistant to vibriostatic compound 0/129

Mahalingam S, Cheong YM, Kan SK, Pang T

Southeast Asian J. Trop. Med. Public Health, 1993 Dec;24(4):779-80.
PMID: 7939959
Matched MeSH terms: Anti-Bacterial Agents/pharmacology*
Comparison of E-test with agar dilution methods in testing susceptibility of N. gonorrhoeae to azithromycin

Yasin RM, Suan KA, Meng CY

Sex Transm Dis, 1997 May;24(5):257-60.
PMID: 9153733

BACKGROUND AND OBJECTIVES: The antimicrobial susceptibility pattern of Neisseria gonorrhoeae varies from one country to another and may also change with time. To monitor these variations and changes, it is desirable to have a method that is simple and reproducible. This study was undertaken to determine the in vitro susceptibility of N. gonorrhoeae to azithromycin and to assess the reliability of results obtained using E-test methodology for determination of the minimum inhibitory concentration (MIC) of azithromycin.
STUDY DESIGN: The MICs for 135 clinical isolates of N. gonorrhoeae were determined by a modified Kirby-Bauer method recommended by the National Committee for Clinical Laboratory Standards against penicillin, cefuroxime, ceftriaxone, norfloxacin, tetracycline, kanamycin, spectinomycin, and azithromycin. The MIC of azithromycin was determined by both the E-test and agar dilution method. All tests were done simultaneously.
RESULTS: The MIC of azithromycin to all 135 isolates ranged from 0.078 to 0.25 microgram/ml with the agar dilution method and from 0.016 to 0.50 microgram/ml with the E-test. The MIC50 and MIC90 of azithromycin were 0.064 microgram/ml and 0.125 microgram/ml, respectively, by the agar dilution method, whereas they are slightly higher by the E-test method. Seventy-six of the isolates were beta-lactamase producers and 69 were high-level tetracycline-resistant N. gonorrhoeae. There was no difference in the MIC50 and MIC90 of azithromycin in these groups of isolates. The percentage agreement within the acceptable +/-1 log2 dilution difference between MICs obtained by E-test and those obtained by the agar dilution method was 97.8%.
CONCLUSIONS: Azithromycin has a very good in vitro antigonococcal activity, and the E-test is a reliable method to determine the MIC of azithromycin against N. gonorrhoeae.

Matched MeSH terms: Anti-Bacterial Agents/pharmacology*
Fulltext In vitro drug susceptibility of Acanthamoeba castellani to chloroquine, ivermectin and fungizon

Rain AN, Radzan T, Sajiri S, Mak JW

Southeast Asian J. Trop. Med. Public Health, 1996 Jun;27(2):319-24.
PMID: 9279996

In vitro sensitivity of Acanthamoeba castellani was tested to three drugs: Chloroquine, ivermectin and fungizone (amphotericin B). Sensitivity was demonstrated to the latter two compounds but not to chloroquine. Thus ivermectin and amphotericin B show promise as therapeutic agents against this parasite.

Matched MeSH terms: Anti-Bacterial Agents/pharmacology*
Conjugal transfer of plasmids and antibiotic resistance among Escherichia coli isolated from animals in a rural area in Sarawak (Malaysia)

Son R, Rusu G, Karim MI

J Appl Microbiol, 1997 Feb;82(2):240-4.
PMID: 12452600

Thirty-six strains of Escherichia coli isolated from animals in Bario, a remote area in Sarawak, Malaysia, were examined for presence of plasmid DNA and their susceptibility to nine antimicrobial agents. Of the total 36 isolates, five bovine and six canine isolates were found to contain plasmid DNA ranging in sizes from 2.6 to 70 kilobases. All were susceptible to chloramphenicol, erythromycin, gentamicin, nalidixic acid and neomycin but resistance to ampicillin (47%), erythromycin (19%), streptomycin (25%) and tetracycline (11%) was observed. Resistance was associated with carriage of a 47 kb (SC98), 70 kb, (SC133) and 56 and 4.6 kb (SC119) plasmids which were transmissible to the Escherichia coli K12 recipient. It is concluded that animals form a potential reservoir of R plasmids carrying E. coli in the study area.

Matched MeSH terms: Anti-Bacterial Agents/pharmacology*
Fulltext The incidence of post-operative wound infection in orthopaedic surgery

Dhillon KS, Kok CS

Med J Malaysia, 1995 Sep;50(3):237-40.
PMID: 8926901

With the increase in the number of orthopaedic surgeons and the aggressive marketing by manufacturing companies, high technology orthopaedic surgery is being more frequently carried out in Malaysia. Post-operative sepsis complicating this type of surgery can have disastrous consequences. No data is available in this country on the incidence of post-operative infection in Orthopaedic Surgery. The aim of this study was to determine the incidence of post-operative infection. A retrospective survey of 703 patients undergoing elective Orthopaedic Surgery in the year 1991 was carried out. We found an overall post-operative infection rate of 6.8% and a deep infection rate of 3.3%. This figure of 3.3% is higher than the internationally accepted figure of less than 2%. A need for ongoing surveillance and concerned effort to reduce the infection rate is stressed.

Matched MeSH terms: Anti-Bacterial Agents/therapeutic use
Fulltext Antibiotic susceptibility of community-acquired Staphylococcus aureus

Tan HS, Ngeow YF, Jamal F

Med J Malaysia, 1986 Mar;41(1):24-9.
PMID: 3796343

55% of a sample of patients in a rural
community, and 76% of a sample of patients and
staff in the local district hospital were found to
be nasal carriers for Staphylococcus aureus. The
in vitro antibiotic susceptibility patterns of 46
strains of S. aureus isolated in nasal carriers as
well as of 43 strains in community-acquired skin
infections were characterised. High levels of
resistance were expressed to penicillin (73%),
cephalexin (64%) and tetracycline (46%).
Resistance to erythromycin (18%) was moderate.
A few strains showed resistance to methicillin
(5 isolates), vancomycin (4), [usidic acid (3),
cotrimoxazole (1), and none to gentamicin.
Penicillin can no longer be recommended for
treating community-acquired S. aureus infections.

Matched MeSH terms: Anti-Bacterial Agents/pharmacology*
Antimicrobial resistance and conjugative R plasmids in Escherichia coli strains isolated from animals in Peninsular Malaysia

Koh CL, Kok CH

Southeast Asian J. Trop. Med. Public Health, 1984 Mar;15(1):37-43.
PMID: 6377513

Fifteen independent E. coli strains of avian, bovine and porcine origin in Peninsular Malaysia were tested for antibiotic resistance and conjugative R plasmids. Eight (53%) isolates were found to be antibiotic resistant. Among them, 37.5% were mono-resistant and 62.5% were resistant to three or more antibiotics, i.e., multi-resistant. All of them were resistant to Tc and sensitive to Gm and Nx. Three of the eight antibiotic resistant strains were able to transfer all or part of their resistance to an E. coli K12 recipient by conjugation. The transfer frequencies of Km, Sm and Tc resistance of the three donors varied between 4.5 X 10(-8) to 6.8 X 10(-7). Analysis of the plasmid profiles of all the three donors and their respective transconjugants after agarose gel electrophoresis provided conclusive evidence that the transferable resistance traits were plasmid-mediated.

Matched MeSH terms: Anti-Bacterial Agents/pharmacology*
Nonconjugative R plasmid-mediated antibiotic resistance in Escherichia coli isolated from animals in Peninsular Malaysia

Koh CL, Kok CH

Southeast Asian J. Trop. Med. Public Health, 1984 Sep;15(3):313-6.
PMID: 6395350

Four of the five veterinary E. coli strains, which were unable to transfer their antibiotic resistance by conjugation, were found to harbour plasmids. Evidence from transformation, agarose gel electrophoresis and curing experiments showed that in strains KE-3, KE-4 and KE-14 a nonconjugative R plasmid carried the gene for resistance to tetracycline. The plasmids in KE-9 were cryptic.

Matched MeSH terms: Anti-Bacterial Agents/pharmacology
Serological ecology of Neisseria gonorrhoeae (PPNG and non-PPNG) strains: Canadian perspective

Dillon JR, Bygdeman SM, Sandström EG

Genitourin Med, 1987 Jun;63(3):160-8.
PMID: 3111978

One hundred and thirty eight penicillinase producing Neisseria gonorrhoeae (PPNG) and 239 non-PPNG strains were characterised serologically using a panel of seven monoclonal antibodies directed against protein 1A and seven against protein 1B. An association between serovar and susceptibility to antimicrobial agents, auxotype, and plasmid content was observed. Serogroup WI strains were more sensitive to penicillin, ampicillin, tetracycline, erythromycin, cefoxitin, and cefuroxime. Sixty five (82%) of the 79 WI strains were typed as being serovar Aedgkih, and 47 (72%) of these strains required arginine, uracil, and hypoxanthine for growth (AUH-). Seventy one (44%) of 160 WII/WIII strains were serovar Bacejk, and 42 (59%) of these required proline, citrulline, and uracil for growth (PCU-) and were plasmid free. Serovars Bcgk, Beghjk, Bacjk, and Bajk were associated with resistance to antimicrobial agents. Analysis of PPNG isolates showed a new serovar, Af, which was associated with strains imported from Malaysia and Singapore that required proline and ornithine for growth (Pro-Orn-) and carried the 24.5 megadalton transfer plasmid, the 2.6 megadalton cryptic plasmid, and the 4.5 megadalton penicillinase producing plasmid. Other associations between serovar and geographical location were noted.

Matched MeSH terms: Anti-Bacterial Agents/pharmacology
Serotype prevalence and antibiotic susceptibility of Shigella strains isolated in Malaysia during 1980 and 1981

Jegathesan M

J Diarrhoeal Dis Res, 1984 Jun;2(2):102-4.
PMID: 6501820
Matched MeSH terms: Anti-Bacterial Agents/pharmacology*
Acute septicaemic melioidosis: a report of seven cases

Puthucheary SD, Lin HP, Yap PK

Trop Geogr Med, 1981 Mar;33(1):19-22.
PMID: 7245336

A report is presented of seven patients with acute septicaemic melioidosis seen at the University Hospital, Kuala Lumpur, Malaysia, during 1976-1979. All had associated disorders which rendered them more susceptible to infection. As prognosis depends on early diagnosis it is important that this disease be considered in the differential diagnosis of a septicaemic illness in such patients from endemic areas. The treatment of choice is a combination of tetracyclines and chloramphenicol, initially used in massive doses, and continued for at least six month to prevent relapses.

Matched MeSH terms: Anti-Bacterial Agents/therapeutic use
Conjugal transfer of multiple antibiotic resistance from hospital isolates of Klebsiella to Escherichia coli

Koh CL, Lim ME, Wong YH

Southeast Asian J. Trop. Med. Public Health, 1983 Sep;14(3):336-40.
PMID: 6362015

Six independent isolates of Klebsiella from hospital environmental sources in Malaysia were found to be resistant to at least ampicillin, carbenicillin, cefoperazone, chloramphenicol, gentamicin and tetracycline. On the basis of their antibiograms, they were divided into four antibiogroups. They transferred all or part of their multiple antibiotic resistance traits to E. coli by conjugation. The results suggest that these Klebsiella strains harbour self-transmissible R plasmids. The significance of these findings are discussed.

Matched MeSH terms: Anti-Bacterial Agents/pharmacology*
Fulltext In vitro activity of aminoglycosides, ureidopenicillins and cephalosporins against P. aeruginosa isolated in Kuala Lumpur

Ngeow YS, Puthucheary SD, Lai PS

Med J Malaysia, 1985 Sep;40(3):196-201.
PMID: 3939567

170 clinical isolates of Pseudomonas aeruginosa were tested for in vitro susceptibility to gentamicin, amikacin, tobramycin, netilmicin, kanamycin, streptomycin, cefotaxime, ceftriaxone, cefoperazone, ceftazidime, moxalactam, azlocillin, piperacillin and ticarcillin. Against 93 gentamicin-sensitive strains, the most active antibiotics were in descending order, ceftazidime, tobramycin, gentamicin, amikacin, and the ureidopenicillins. Against 77 gentamicin-resistant strains, only ceftazidime, amikacin and moxalactam had mode minimum inhibitory concentrations within achievable peak serum levels after standard therapeutic dosage. There was no correlation between cephalosporin resistance and aminoglycoside resistance except for cefoperazone, which, together with the ureidopenicillins and ticarcillin, showed marked decrease in activity against gentamicin-resistant strains.

Matched MeSH terms: Anti-Bacterial Agents/pharmacology
Acute organic brain syndrome due to drug-induced eosinophilia

Ng SC, Lee MK, Teh A

Postgrad Med J, 1989 Nov;65(769):843-4.
PMID: 2616421

A 72 year old man developed acute organic brain syndrome associated with marked eosinophilia following self medication with a variety of drugs. Investigations revealed no other known causes of eosinophilia. Withdrawal of drugs resulted in dramatic drop in eosinophil count paralleled by clinical resolution of neurological problems. To our knowledge drug-induced eosinophilia has not previously been associated with acute organic brain syndrome.

Matched MeSH terms: Anti-Bacterial Agents/adverse effects
Fulltext Susceptibility of 57 strains Ps. pseudomallei to some new B-lactams and other antibiotics

Puthucheary SD, Parasakthi N

Med J Malaysia, 1987 Dec;42(4):248-51.
PMID: 3454397

Fifty seven strains of Pseudomonas pseudomallei were tested for in vitro susceptibility to 15 antimicrobial agents. Amongst the generally recommended antibiotics for therapy of melioidosis, only 86%, 84% and 58% of the strains were found to be sensitive to trimethoprim-sulphamethoxazole, chloramphenicol and tetracycline respectively. Of the newer B-Iactams, in descending order of activity were, ceftazidime, ceftriaxone, cefotaxime, cefoperazone and cefuroxime. But on a weight for weight basis, ceftazidime was the most active agent and as such, may be considered in the therapy of acute septicaemic melioidosis."

Matched MeSH terms: Anti-Bacterial Agents/pharmacology*
Antibiotic resistance and conjugative R plasmids in clinical isolates of Enterobacteriaceae in Peninsular Malaysia

Koh CL

Trans R Soc Trop Med Hyg, 1986;80(1):158-61.
PMID: 3726978

Twenty-five strains of enterobacteria, isolated from man in Peninsular Malaysia and consisting of seven Enterobacter spp., five Escherichia coli, five Salmonella spp., four Klebsiella spp., two Shigella spp., one Proteus sp. and and one Providencia sp., were tested for antibiotic resistance and conjugative R plasmids. They were all sensitive to nalidixic acid and resistant to at least three antibiotics. The number of resistances ranged from 3 to 11 antibiotics, including cefoperazone and sisomicin (two) newly released antibiotics), in addition to common drugs of current use. Of the 25 isolates, 19 (76%) conjugally transferred, at varied frequencies, at least two resistance determinants. Results from equilibrium density gradient centrifugation, agarose gel electrophoresis and transformation experiments provided proof that the transferable resistances were plasmid-mediated. Restriction endonuclease cleavage patterns showed that the plasmids from Proteus strain K005 and Providencia strain K001 may be identical.

Matched MeSH terms: Anti-Bacterial Agents/pharmacology*
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*
Fulltext Invasive pyogenic infection and infective endocarditis due to Streptococcus anginosus: A case report

Cheng CW, Feng CM, Chua CS

Medicine (Baltimore), 2019 Nov;98(48):e18156.
PMID: 31770258 DOI: 10.1097/MD.0000000000018156

RATIONALE: Streptococcus anginosus mostly colonizes the digestive and genitourinary system, including the oropharyngeal region. It commonly causes invasive pyogenic infection, but less likely causes infective endocarditis (IE).
PATIENT CONCERNS: An 18-year-old woman who had an underlying mitral valve prolapse without mitral regurgitation presented to our hospital with low-grade fever, left leg weakness, and left abdominal pain. She was diagnosed with brain infarction and microabscess as well as IE. The patient totally recovered after the 6-week course of intravenous antibiotics.
DIAGNOSIS: Brain magnetic resonance imaging revealed brain infarction and microabscess. Abdominal computed tomography revealed splenic and left renal infarction. Three sets of blood culture were positive for S anginosus. Transthoracic echocardiogram identified mitral valve prolapse with moderate eccentric mitral valve regurgitation, and a 0.3 × 0.6-cm vegetation was found on the left mitral valve. All of these results meet the modified Duke criteria.
INTERVENTIONS: The abdominal pain and left leg weakness were improving after 2 weeks of intravenous antibiotics treatment. No neurological sequelae were noted after completing the 6-week course of medical treatment.
OUTCOMES: The patient was successfully treated and discharged after completing the 6-week intravenous antibiotics treatment.
LESSONS: IE should be considered in young patients with native valve disease who have prolonged fever. Though S anginosus commonly causes invasive pyogenic infection, patients with native valve disease should be checked for IE.

Matched MeSH terms: Anti-Bacterial Agents/administration & dosage*

Filters

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links