Vancomycin
M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson in Kucers’ The Use of Antibiotics, 2017
A prospective, randomized clinical trial among drug abusers was conducted to assess the efficacy and safety of a short course of a combination of a glycopeptide (vancomycin or teicoplanin) and gentamicin compared with a combination of cloxacillin and gentamicin for the treatment of right-side endocarditis caused by S. aureus. Therapeutic success was significantly more frequent with cloxacillin than with a glycopeptide. No adverse effects were noted among the patients in the cloxacillin group. A 14-day course of vancomycin or teicoplanin plus gentamicin was ineffective and associated with a high rate of clinical and microbiological failure (Fortun et al., 2001).
High-Performance Liquid Chromatography
Adorjan Aszalos in Modern Analysis of Antibiotics, 2020
Cloxacillin in oral dosage forms was quantified using an ethylsilane column with KH2PO4, pH 4.5-acetonitrile (80:20) mobile phase flowing at 1.5 ml/min (30°C) through a 254 nm detector [270]. The other isoxazole penicillins, oxacillin and dicloxacillin, were also resolved from each other, along with cloxacillin degradation products, cloxalloic acid and two minor unknown peaks. Responses for cloxacillin were linear from 0.11 to 0.65 mg/ml.
Surgical Aspects Of Fever
Benedict Isaac, Serge Kernbaum, Michael Burke in Unexplained Fever, 2019
Most common infections are staphylococcal, and are managed by catheter removal. In severe infections, immunocompromised patients, and those with prosthetic vascular grafts, one should add penicillinase-resistant antibiotics, such as Cloxacillin, and cephalosporins. The most common pathogen, Staphylococcus epidermidis, is treated initially with Vancomycin. If laboratory tests then show sensitivity to Cloxacillin, this should be used.
Treatment of lactational breast abscesses with cavity diameter larger than 5 cm via combined ultrasonography-guided percutaneous catheter placement and hydrostatic pressure irrigation
Published in Journal of Obstetrics and Gynaecology, 2022
Zhihui Du, Lei Liu, Xing Qi, Peisen Gao, Shumin Wang
Warm saline was introduced via the catheter at an initial pressure of 100 cm H2O and increased to a maximum of 120 cm H2O. Approximately 500–800 ml of warm saline was irrigated through the lesion once a day at the highest velocity tolerable to the patients until the outflowing saline from the lesion appeared relatively clear. Follow-up US examination was performed in all cases twice per week until the lesions resolved. The catheters were removed when the abscess was no longer visible upon US. For those resolved, they were reviewed again at 12 weeks post-drainage after hospital discharge. For breastfeeding women, the infants were to continue to nurse from the unaffected breast, and the breast with the abscess was emptied by means of a pump to prevent milk stasis. These patients were given oral cloxacillin 500 mg four times daily for 10 days in the meantime.
Reviewing the WHO guidelines for antibiotic use for sepsis in neonates and children
Published in Paediatrics and International Child Health, 2018
Aline Fuchs, Julia Bielicki, Shrey Mathur, Mike Sharland, Johannes N. Van Den Anker
WHO provides guidelines for the management of common childhood illnesses, through the Pocket Book of Hospital Care for Children published for the first time in 2005 [5]. The second edition was published in 2013 [6]. It is one of a series of documents and tools supporting the Integrated Management of Childhood Illness (IMCI). These guidelines focus on management of the major causes of childhood mortality in countries with limited health care (and other) resources. Recommendations for preventing neonatal infection and for the management of possible serious bacterial infection remain the same in the second edition. It recommends providing prophylactic intramuscular (IM) or intravenous (IV) ampicillin and gentamicin in neonates with documented risk factors for infection for at least 2 days and then to reassess. Treatment should be continued only if there are signs of sepsis (or positive blood culture). It recommends hospitalisation and IM or IV antibiotic therapy with a combination of gentamicin and benzylpenicillin or ampicillin for at least 7–10 days in infants aged <2 months who fulfil the case definition of serious bacterial infection. If infants are deemed to be at risk of staphylococcal infection, IV cloxacillin and gentamicin are recommended.
No increase in readmissions or adverse events after implementation of fast-track program in total hip and knee replacement at 8 Swedish hospitals: An observational before-and-after study of 14,148 total joint replacements 2011–2015
Published in Acta Orthopaedica, 2018
Urban Berg, Erik BüLow, Martin Sundberg, Ola Rolfson
To define the fast-track programs and the time of implementation a questionnaire was sent to hospitals performing elective hip and knee replacements in the Swedish Region Västra Götaland, a county council with a population of 1.7 million inhabitants. In 3 clinics without weekend service and exclusively patients with ASA 1–2, a care program based on the fast-track principles had already been implemented before 2011. These clinics were excluded from our study. In 8 public hospitals fast-track care programs were implemented between January 2012 and November 2014 at different times. We defined that fast-track was implemented when the following criteria for standard of care were met: (1) admission on the day of surgery, (2) mobilization within 3–6 hours after the operation, (3) functional discharge criteria in practice, and (4) an intended median length of stay (LOS) not more than 3 days. The patients were informed about the expected LOS, but the decision on discharge followed the functional ability and pain relief. However, regardless of whether the care program was defined as fast-track or not, the standard of care included written and oral structured information at a preoperative visit with a multiprofessional team 1–3 weeks before surgery, multimodal analgesia for pain relief, and tranexamic acid to reduce bleeding. Spinal anesthesia was routinely preferred supplemented by local infiltration analgesia in knee replacements but not in hips. 3 doses of cloxacillin were given on the day of surgery. The length of antithrombotic prophylaxis was 10 days in knees and 28–30 days in hips, but the antithrombotic drug varied between hospitals. No drains were used, a urinary catheter only in selected cases, and tourniquet in TKR was optional depending on the surgeon’s preference.
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