Antibiotics agents/therapy

Because the progression of infection in neutropenic patients can be rapid, empirical antibiotic therapy should be administered quickly to such patients once fever is documented. Currently, the most commonly used initial antibiotic agent is cefipime, a fourth-generation cephalosporin that has good antipseudomonal coverage as well as adequate coverage against viridans streptococci and pneumococci.23... 

Topical steroids are not indicated for most cases of acute bacterial conjunctivitis. The exception is acute conjunctivitis accompanied by severe inflammation or pseudomembranes or true membranes. Concurrent topical antibiotic-steroid therapy hastens resolution of inflammatory response however, caution is prudent in cases in which the infectious agent has not been definitively identified and until the infection has clearly responded to antibiotic therapy. 

The Elderly. Older patients may be considered to have a degree of inununosuppression due to the waning of immune defenses associated with aging choices of antibiotic agents are no different from those of younger patients with typical lesions, but corticosteroid therapy may be reduced or eliminated out of consideration for altered host defenses. 

Streptomyces coerulerubidos yielded a tetracyclic aminosugar containing an antibiotic named daunorubicin (rubidomycin, Cerubidine ), which exhibited actinomycinlike antitumor activity. Severe cardiotoxicity, however, limited its clinical use, particularly as single agent therapy. 

Figure 7.4 Under the right circumstances, it may be necessary to initiate therapy with several antibiotic agents.

Despite the numerous well-known complications of naturopathy and antioxidant therapy (antioxidants could blunt the effect of standard therapies, particularly alkylating, platinum, and tumor antibiotic agents, which are oxidative in nature), the biomedical research community has witnessed a remarkable optimism in the attitude of many conventional practitioners toward naturopathy and antioxidant therapy in recent years. Although this may appear as a theoretical concern, a plethora of pubhshed papers shows that this proposed interaction of anti- and pro-oxidant therapies has tremendous imphcations, and it is time to put this controversy in the proper perspective. Approaches to cancer therapy have been remarkably consistent for the last several decades. Smgeiy, radiation, and chemotherapy alone—or their reasonable... 

A number of studies have unequivocally demonstrated that anti-secretory/anti-biotic drug combinations including a PPI rather than an H2 receptor antagonist provide better eradication of H. pylori. Furthermore, the combination of a PPI and one or two antibiotic agent achieves H. pylori eradication rates indistinguishable from those found using bismuth triple therapy. Such studies have also noted an acceleration in rapid ulcer healing, less antimicrobial... 

Antiviral Agents. Although a number of antibiotics have been shown to have some sort of antiviral activity, only vidarabine [5536-17-4] (adenine arabinoside) is used clinically against viral infections at this time. As the need for new antiviral agents (qv) increases and new screening procedures are developed, one would expect the discovery of other new effective antiviral antibiotics that could be used safely in human therapy. 

Control of tuberculosis, long one of the scourges of mankind, began with the introduction of effective antibacterial agents. Thus, this disease was treated initially with some small measure of success with various sulfa drugs the advent of the antibiotic, streptomycin, provided a major advance in antitubercular therapy, as did the subsequent discovery of isoniazid and its analogs. 

Empiric antibiotic therapy is an appropriate approach to traveler s diarrhea. Eradication of the causal microbe depends on the etiologic agent and its antibiotic sensitivity. Most cases of traveler s diarrhea and other community-acquired infections result from enterotoxigenic (ETEC) or enteropathogenic (EPEC) Escherichia coli. Routine stool cultures do not identify these strains primary empiric antibiotic choices include fluoroquinolones such as ciprofloxacin or levofloxacin. Azithromycin may be a feasible option when fluoroquinolone resistance is encountered. 

If the presence of SBP is suspected, empiric antibiotic therapy with a broad-spectrum anti-infective agent should be initiated until cultures and susceptibilities are available (Fig. 19-5).45,46 In the setting of presumed infection, delaying... 

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