Clarithromycin was administered intravenously to 55 rabbits to evaluate its effect on experimental sepsis caused by multidrug-resistant Pseudomonas aeruginosa. Acute pyelonephritis was induced after ligation of the right ureter and injection of 10 8 CFU of the test isolate per kg of body weight into the renal pelvis. The animals were divided into six groups: group A, controls; group B, rabbits that received one intravenous dose of 80 mg of clarithromycin per kg concomitantly with bacterial challenge; group C, rabbits that received two doses of clarithromycin, the second one of which was given 2 h after the first one; group D, rabbits that received 15 mg of amikacin per kg; group E, rabbits that received one dose of clarithromycin and amikacin; and group F, rabbits that received two doses of clarithromycin and amikacin. Serum endotoxin levels were estimated by the QCL-1000 Limulus amoebocyte lysate assay, tumor necrosis factor alpha (TNF-␣) levels were measured by a bioassay, and malondialdehyde (MDA) levels were measured by the thiobarbiturate assay. Viable bacterial counts in various tissue samples were also assessed. The mean survival times of the animals in groups A, B, C, D, E, and F were 4.50, 7.69, 4.07, 4.55, 11.55, and 11.60 days, respectively (P ؍ 0.033 for group D versus group F, P ؍ 0.006 for group D versus group E, P ؍ not significant for group B versus group E, P ؍ 0.042 for group C versus group F). Serum endotoxin levels were similar between groups at all sampling times; TNF-␣ and MDA levels in groups B, C, E, and F decreased significantly over follow-up. The numbers of viable bacterial cells in the infected kidney were similar among the groups; those in the liver, spleen, lungs, and mesenteral lymph nodes were significantly decreased in groups B, E, and F compared to those in groups A and D. It is concluded that a prolongation of survival in animals with experimental sepsis caused by multidrug-resistant P. aeruginosa was achieved after coadministration of clarithromycin and amikacin and that the increased survival was probably attributable to the immunomodulatory properties of clarithromycin.Clarithromycin is a macrolide classically known to possess an antimicrobial spectrum that includes gram-positive cocci and atypical pathogens (23). However, an increasing body of evidence suggests that clarithromycin possesses considerable antiinflammatory and immunomodulatory properties, recommending its administration for the treatment of chronic inflammatory conditions like diffuse panbronchiolitis and cystic fibrosis (11,21,26). Its immunomodulatory properties are observed in vitro at concentrations close to 10 g/ml (14). On the basis of that finding, intravenous administration of clarithromycin leading to the same levels in blood might be beneficial for the treatment of an acute inflammatory state like sepsis.Pseudomonas aeruginosa is a common pathogen that is involved in nosocomial sepsis and that is often characterized nowadays by multidrug resistance (18). In the present study, intravenous clar...
Background: Thalidomide is an inhibitor of tumour necrosis factor-alpha (TNFα) that has been proven effective for the treatment of experimental sepsis by Escherichia coli. It was tested whether it might behave as an effective immunomodulator in experimental sepsis by multidrug-resistant (MDR) Pseudomonas aeruginosa.
Abstract. Background/Aim: Cytomegalovirus (CMV) infection is a common disease especially in young adults. Thromboembolism like deep vein thrombosis and pulmonary embolism is increased among patients with CMV infection. Most cases represent immunocompromised patients usuallyCytomegalovirus (CMV) infection is usually asymptomatic or resembles infectious mononucleosis syndrome, which is characterized by fever, malaise, muscular-skeletal pain, lymphadenopathy and atypical lymphocytosis. Of note, the reports of thromboembolic events such as pulmonary embolism (PE) associated to acute CMV infection are increasing (1). Venous thromboembolism has been reported in association with CMV infection both in immunocompromised and immunocompetent patients. In the latter population, it is yet not determined whether CMV alone provokes venous thromboembolism (VTE) or other predisposing conditions are involved (2, 3). The correct assessment of the patient's clinical status, in association with the procoagulant risk factors could be useful to reach the diagnosis of PE. We present and analyze the first -to our knowledge-case of CMV related PE in an immunocompetent young patient, treated with novel oral anticoagulants (NOACs). Case ReportA 25-year-old male presented to the emergency room with sudden onset of chest pain. One month prior to the admission, he had developed persistent fever and cough, and following detailed assessment, diagnosis of CMV infection was established. There was no history of smoking, alcohol intake or other comorbidities. His temperature was 36.9˚C, blood pressure was 125/55, heart rate 125/min, respiratory rate 22/min with oxygen saturation 100% at 2lt of oxygen.
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