Plasma levels of omeprazole (OPZ) in Japanese male subjects were compared after a single oral administration of 20 mg of OPZ enteric-coated tablets with and without coadministration of Maalox (MLX suspension) or Maalox dry suspension granules (MLX granules). After coadministration of MLX granules, plasma levels of OPZ markedly decreased, and area under the blood concentration-time curve (AUC) decreased to 26% of that of OPZ alone. In contrast, only a slight decrease in AUC was observed after coadministration of OPZ and MLX suspension. Both MLX suspension and MLX granules exhibited similar degrees of the inhibitory effect on the renal excretion of levofloxacin. It was suggested that a specific and unexpected drug interaction occurred between OPZ enteric-coated tablets and MLX granules via a distinct mechanism from that reported for fluoroquinolones and MLX suspension.
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All isolates were identified using the CAMP test and the latex-agglutination assay and serotyped using a Strep-B-Latex kit, after which they were assessed for antibiotic susceptibility, macrolide-resistance genes, and MLST profiles.
Antibiotic susceptibility of conjunctival bacterial strains isolated from 164 patients undergoing intraocular surgery was determined using the Kirby-Bauer disk-diffusion technique.
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We defined MDRP as resistance to amikacin, imipenem and levofloxacin. We had eight cases of MDRP-causing CAUTI in hospitalized neurogenic bladder patients caused by spinal cord injury in 2 months. Pulse-field gel electrophoresis (PFGE) was performed for epidemiological studies. We assessed prevention measures against MDRP emergence from the 2nd month, such as surveillance of CAUTI and infection control, and evaluated the outcomes of these measures over a total of 8 months.
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We identified all hospital-acquired isolates from 14 hospitals in the Northern California Kaiser Permanente health care delivery system between 1998 and 2003 and determined their susceptibility to ciprofloxacin. For each facility, we determined the number of days of fluoroquinolone use per 1000 patient-days, by calendar quarter. We used a logistic regression model to analyze the data, with susceptibility status as the outcome variable. Hospital-level rates of use of the 3 fluoroquinolones were the predictors of interest; we adjusted for year, for use of nonquinolone antimicrobials, and for patient variables, including the number of days spent in the hospital in the prior year and fluoroquinolone use in the prior year. The model tested whether isolates from those facilities with higher rates of use of antimicrobials were more likely to be nonsusceptible to ciprofloxacin.
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The usage of antibiotics in ARS is widespread and there seems to be only slight added benefit in the usage of antibiotics over placebo in the treatment of ARS. Hence, larger scale studies should be done in the future to confirm the results of these studies.
Haemophilus influenzae is an important causative pathogen of community-acquired respiratory infection in China. In this study we investigated 37 H. influenzae strains isolated from patients with community-acquired respiratory tract infections (CARTI) in Shanghai city between Dec 2008 and Apr 2009. H. influenzae clinical isolates were identified, and b-lactamase production tests were conducted and minimal inhibitory concentrations(MIC) were measured. Pulsed-field gel electrophoresis(PFGE) was introduced as an effective finger printing method. Two isolates (5.4%) were verified as serotype b strains, and 30 strains (81.1%) were nontypeable H. influenzae. Furthermore, 10 (27.0%) were b-lactamase-producing ampicillin-resistance (BLPAR) (TEM-1 type)strains, 11 (29.8%) were low-b-lactamase-nonproducing ampicillin-resistant H. influenzae (Low-BLNAR) strains,and the rest were b-lactamase-negative ampicillin-susceptible(BLNAS) strains. Minimum inhibitory concentrations(MIC90; lg/ml) were 2 for ampicillin/sulbactam, 0.05 force fotaxime, 16 for cefaclor, 2 for azithromycin, 0.12 for levofloxacin, and 4 for imipenem. Fingerprint typing by PFGE revealed 23 independent patterns for the isolates. Pattern A (defined in this study) was predominant in BLPAR strains, and a variety of other patterns were detected in Low-BLNAR and BLNAS strains. Although the incidence of ampicillin resistant H. influenzae is increasing in CARTI patients in China, current antimicrobial chemotherapy seems to be effective.
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The purpose of this study was to clarify the various clinical presentations, incidence, and complications associated with tuberculosis (TB), as well as patient survival in heart transplantation (HTx) recipients. A retrospective review of 177 case records of HTx recipients from May 1989 to April 2003 were evaluated for their clinical course, diagnostic procedures, treatment, and survival. TB was diagnosed by culture. TB was proven in five (2.8%) patients. There were three pulmonary lesions and two extrapulmonary lesions. TB was diagnosed at 3.5 to 85 months after HTx. Pulmonary lesions were detected by cultures of sputum, bronchoalveolar lavage, or pleural effusion. For extrapulmonay lesions, one subject had neck lymphadenopathy shown by biopsy and culture to be TB; another suffered from swelling of the finger joints which upon culture of the aspirate proved to be TB. Treatment consisted of isoniazid (INH), rifampin (RIF), ethambutol, pyrazinamide, streptomycin (STR), ciprofloxacin (Ciproxin), and levofloxacin (Cravit). During the use of RIF, the daily dosage of cyclosporine (CsA) or tacrolimus was increased to maintain appropriate levels. Because of severe hepatotoxicity and interference with CsA, RIF was withdrawn and STR given in the last three patients. In addition, ciprofloxacin was given in the patient with miliary TB. Levofloxacin was given to the other two patients. All patients survived the TB infection under treatment with at least three drugs. There were five clinical presentations of TB in our HTx recipients. Because of the high incidence of hepatitis and severe drug interaction with CsA or tacrolimus on RIF treatment, avoiding the use of RIF but treatment with at least three drugs is recommended.
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Forty patients (median age, 72 years; 77.5% males) with S. maltophilia infection were identified. The main type of infection was lower respiratory tract infection (97.5%); one patient had a bloodstream infection. A total of 97.5% patients were infected with two or more organisms at the same time. The main characteristics of the patients were prolonged use of mechanical ventilation, urethral catheter, and central venous catheter before the infections occurred. The case number of infection was not different in the four seasons. High in vitro sensitivity was observed to minocycline (91.2%), levofloxacin (85.3%), and trimethoprim-sulfamethoxazole (79.4%). Most patients received therapy with a combination of agents. The crude mortality was 50%. By multivariate analysis, low albumin content and hypotension were the independent prognostic factors for mortality.
Although the peptide alone exerted no antimicrobial effect, it reduced the MICs of colistin, levofloxacin, erythromycin, vancomycin and rifampicin for P. aeruginosa PAO1 by 4-fold or more. Time-kill tests revealed bacterial numbers were significantly reduced after 2 h of incubation with the peptide plus colistin or levofloxacin. Moreover, in the presence of the peptide, expression of OprM was reduced by a third, and OM permeability was increased. The combination of the peptide (2.08 mg/kg) and colistin (1.25 mg/kg) significantly reduced P. aeruginosa by more than 1 log cfu/mL in a mouse pneumonia model.
A total of 517 S. aureus isolates collected between January 2009 and March 2012 from six cities in China were subjected to antibiogram analysis and molecular typing, including staphylococcal cassette chromosome mec typing, multilocus sequence typing, staphylococcal protein A gene typing and PFGE typing.