RESUMO
Abstract Acute localized exanthematous pustulosis is a localized variant of acute generalized exanthematous pustulosis, which is characterized by the eruption of multiple scattered pustules following drug administration. A 72-year-old woman presented with multiple erythematous pustules on her face, which had appeared two days after using cefoperazone and sodium sulbactam. Histopathological findings showed subcorneal pustules and mixed inflammatory cell infiltration in the dermis. The pustules resolved within about two weeks after the patient discontinued the antibiotics. This report discusses the case of a woman with a cutaneous drug reaction consistent with acute localized exanthematous pustulosis that occurred after cefoperazone and sodium sulbactam were administered.
Assuntos
Humanos , Feminino , Idoso , Sulbactam/efeitos adversos , Cefoperazona/efeitos adversos , Pustulose Exantematosa Aguda Generalizada/etiologia , Pustulose Exantematosa Aguda Generalizada/patologia , Antibacterianos/efeitos adversos , Pele/patologia , Fatores de Tempo , BiópsiaRESUMO
Acute localized exanthematous pustulosis is a localized variant of acute generalized exanthematous pustulosis, which is characterized by the eruption of multiple scattered pustules following drug administration. A 72-year-old woman presented with multiple erythematous pustules on her face, which had appeared two days after using cefoperazone and sodium sulbactam. Histopathological findings showed subcorneal pustules and mixed inflammatory cell infiltration in the dermis. The pustules resolved within about two weeks after the patient discontinued the antibiotics. This report discusses the case of a woman with a cutaneous drug reaction consistent with acute localized exanthematous pustulosis that occurred after cefoperazone and sodium sulbactam were administered.
Assuntos
Pustulose Exantematosa Aguda Generalizada/etiologia , Pustulose Exantematosa Aguda Generalizada/patologia , Antibacterianos/efeitos adversos , Cefoperazona/efeitos adversos , Sulbactam/efeitos adversos , Idoso , Biópsia , Feminino , Humanos , Pele/patologia , Fatores de TempoRESUMO
The present study is a non-inferiority study based on a descriptive and comparative case series for comparison of generic vs. original intravenous antimicrobials in septic oncology patients at an oncology private ICU. 1906 cancer patients admitted to Arturo Lopez Perez Foundation, Chile, were included in this study. After recruitment, a first retrospective group of 206 septic cancer patients recorded from 1st January, 2008 until July 14th, 2010, treated with original antibiotics (cefoperazone-sulbactam, imipenem-cilastatin, piperacillin-tazobactam) were included for analyses and a second prospective group of 143 septic cancer patients recorded from July 15th, 2010 until January 02, 2013, treated with the same but generic antibiotics were also included for comparisons. The trial protocol was developed in accordance with Helsinki and Good Clinical Practices recommendations. The results of this study showed no significant differences between the 2 groups in days of treatment, rate of success and lab test determinations (white cell count, PCR and procalcitonin), with lower, but not significant, total bed days and CPU bed days for generic antibiotics. Therefore, we conclude that the safety and efficacy of the generic antibiotics cefactam®, imipen® and Piperazam® are not inferior to original antibiotics for the treatment of severe sepsis in hospitalised patients at the Arturo Lopez Perez Foundation.
Assuntos
Antibacterianos/efeitos adversos , Antibacterianos/uso terapêutico , Cefoperazona/uso terapêutico , Cilastatina/uso terapêutico , Imipenem/uso terapêutico , Serviço Hospitalar de Oncologia , Ácido Penicilânico/análogos & derivados , Sepse/tratamento farmacológico , Sulbactam/uso terapêutico , Administração Intravenosa , Antibacterianos/administração & dosagem , Cefoperazona/efeitos adversos , Cilastatina/efeitos adversos , Combinação Imipenem e Cilastatina , Combinação de Medicamentos , Medicamentos Genéricos/efeitos adversos , Medicamentos Genéricos/uso terapêutico , Feminino , Humanos , Imipenem/efeitos adversos , Masculino , Pessoa de Meia-Idade , Ácido Penicilânico/efeitos adversos , Ácido Penicilânico/uso terapêutico , Projetos Piloto , Piperacilina/efeitos adversos , Piperacilina/uso terapêutico , Combinação Piperacilina e Tazobactam , Estudos Prospectivos , Estudos Retrospectivos , Sulbactam/efeitos adversos , Resultado do TratamentoRESUMO
Recent studies have highlighted the emergence of infections involving multiresistant Acinetobacter clinical isolates. Sulbactam offers direct antimicrobial activity against Acinetobacter species. Accordingly, co-administration of sulbactam with ampicillin or cefoperazone offers the potential of effective empirical therapy against Acinetobacter and other bacteria such as Enterobacteriaceae in institutions in which they are susceptible. Many in vitro studies have indicated that Acinetobacter remains fully susceptible to ampicillin-sulbactam or cefoperazone-sulbactam. Furthermore, ampicillin-sulbactam has proven clinically effective and well tolerated in the treatment of severe acinetobacter infections, including bacteremia. Therefore, ampicillin-sulbactam is a sensible option for the treatment of life-threatening acinetobacter infections.
Assuntos
Infecções por Acinetobacter/tratamento farmacológico , Infecções por Acinetobacter/microbiologia , Acinetobacter/fisiologia , Farmacorresistência Bacteriana Múltipla , Sulbactam/uso terapêutico , Acinetobacter/genética , Infecções por Acinetobacter/epidemiologia , Ampicilina/efeitos adversos , Ampicilina/uso terapêutico , Antibacterianos/efeitos adversos , Antibacterianos/uso terapêutico , Cefoperazona/efeitos adversos , Cefoperazona/uso terapêutico , Combinação de Medicamentos , Farmacorresistência Bacteriana Múltipla/genética , Humanos , Testes de Sensibilidade Microbiana , Sulbactam/administração & dosagem , Sulbactam/efeitos adversosRESUMO
Sao relatados quatro casos sugestivos de nefrite intersticial aguda relacionados ao uso de antibióticos, em pacientes internados na enfermaria de Clínica Médica do Hospital Universitário Lauro Wanderley, no período de abril de 1992 a janeiro de 1993. Os pacientes foram admitidos com quadro infeccioso grave, receberam antibióticos beta-lactâmicos, desenvolvendo, no curso do tratamento, síndrome de hipersensibilidade caracterizada por febre, exantema, eosinofilia e alteraçoes urinárias. Concomitantemente, foi realizada revisao da literatura a cerca do assunto, discutindo-se sua etiopatogenia e tratamento.