Proteus infection , treatment

Skin and skin-structure infections caused by E. coli, Klebsiella sp., Serratia sp., Acinetobacter sp., Enterobacter sp., P. aeruginosa indole-positive Proteus sp., P. mirabilis, Bacteroides sp., including B. fragilis, anaerobic cocci, enterococci Bone and joint infections caused by P. aeruginosa, enterococci, Bacteroides sp., and anaerobic cocci Gonococcal infections, treatment of uncomplicated gonococcal urethritis... 

Urinary tract infections Nalidixic acid is indicated for the treatment of urinary tract infections (UTIs) caused by susceptible gram-negative microorganisms, including the majority of Escherichia coli, Enterobacter species, Klebsiella species, and Proteus species. Perform disc susceptibility testing with the 30 meg disc prior to administration of the drug and during treatment if clinical response warrants. 

Nitrofurantoin is bacteriostatic and bactericidal for many gram-positive and gram-negative bacteria but P aeruginosa and many strains of proteus are resistant. There is no cross-resistance between nitrofurantoin and other antimicrobial agents and resistance emerges slowly. As Escherichia coli resistant to trimethoprim-sulfamethoxazole and fluoroquinolones has become more common, nitrofurantoin has become an important alternative oral agent for treatment of uncomplicated urinary tract infection. 

Kanamycin can be used for short-term treatment of severe infections caused by susceptible strains (for example Escherichia coli, Proteus species, Enterobacter aerogenes, Klebsiella pneumoniae, Serratia marcescens, and Mima-Elerellea) that are resistant to other less ototoxic aminoglycosides. It is not indicated for long-term therapy, for example in tuberculosis. 

Carbenicillin Indanyl Sodium, USP. Efforts to obtain orally active forms of carbcnicillin led to the eventual rclea.se of the S-indanyl ester carbenicillin indanyl. 6- 2-phcnyl- 2-(S-indanyloxycarbonyl)acctamidolpenicillanic acid (Geocil-lin). in 1972. Approximately 40 >(- of (he usual oral dose of indanyl carbenicillin is absorbed. After ab.sorption. the ester is hydrolyzed rapidly by plasma and tissue e.stcrases to yield carbcnicillin. Thu.s. although the highly lipophilic and highly protein-bound e.ster has in vitro activity comparable with that of carbenicillin. its activity in vivo is due to carbenicillin. Indanyl carbenicillin thus provides an orally active alternative for (he treatment of carbenicillin-sensiiivo sy.stcmic and urinary tract infections caused by Pseudomonas spp.. indole-positive Proteus. spp.. and seleeted species of Gramnegative bacilli. 

Gentamicin. — This 2-deoxystreptamine-containing amino-glycosidic antibiotic is related to the neomycins, the paromomycins and kanamycin. Clinical reports indicated gentamicin is a drug of choice for parenteral and topical treatment of infections caused by Pseudomonas aeruqinosa 4 and Proteus mirabilis. Forty-seven of 50 patients topically treated for various bacterial infections were cleared of... 

Carbenicillin is indicated in the treatment of acute and chronic infections of the upper and lower urinary tract and in asymptomatic bacteriuria due to susceptible strains of Escherichia coli, Proteus mirabilis, Morganella morganii, Providencia rettgeri, P. vulgaris, Pseudomonas, Entero-bacter, and enterococci. It is also indicated in the treatment of prostatitis due to susceptible strains of E. coli, enterococcus (S. faecalis), P. mirabilis, and Enterobacter species. 

Ticarcillin, extended-spectrum penicillin, alpha-carbox-ypenicillin, is indicated for the treatment of bacterial septicemia, skin and soft-tissue infections, acute and chronic respiratory tract infections caused by susceptible strains of Pseudomonas aeruginosa, Proteus species (both indole-positive and indole-negative), and Escherichia coli and for genitourinary tract infections (complicated and uncomplicated) due to susceptible strains of P. aeruginosa, Proteus species (both indole-positive and indole-negative), E. coli, Enterobacter, and Streptococcus faecalis (enterococcus). 

A urinary antiseptic, this agent is not effective in the treatment of urinary tract infections caused by proteus. Mutual antagonism may occur if this drug is used concomitantly with sulfonamides. 

Ampicillin is essentially equivalent to benzylpenicillin for pneumococcal, streptococcal, and meningococcal infections, and many strains of Gram-negative Salmonella, Shigella, Proteus mirabllls, and Escherichia coll, as well as many strains of Haemophilus influenzae and Neisseria gonorrhoeae, respond well to oral treatment with ampicillin. 

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