Infectious Complications After Cardiac Transplantation in Man

Stinson, Edward B.; Bieber, Charles P.; Griepp, Randall B.; Clark, David A.; Shumway, Norman E.; Remington, Jack S.

doi:10.7326/0003-4819-74-1-22

Cited by 145 publications

(40 citation statements)

References 27 publications

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“…Nine other patients begun on a similar schedule manifested gastrointestinal symptoms attributed to the clotrimazole and were unable to complete the study. Concentrations of active drug in the urine were less than 1 N of the administered dose.Systemic fungal infections contribute significantly to the morbidity and mortality of patients with hematological malignancies (1, 7) and of transplant patients receiving immunosuppressive therapy (13,17,20 (Fig. 1).…”

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confidence: 99%

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Clotrimazole (Bay b 5097): In Vitro and Clinical Pharmacological Studies

Burgess

Bodey

1972

Antimicrob Agents Chemother

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Clotrimazole (Bay b 5097) is a new synthetic antifungal drug with in vitro activity against Candida spp., Torulopsis glabrata, and Saccharomyces spp. Pharmacological studies in man after the oral administration of 1.5 and 3 g of clotrimazole produced mean peak concentrations in the serum of 1.16 and 1.29 mg/ml, respectively, 2 hr after administration. In six patients taking 1.5 g of clotrimazole every 6 hr, there was a progressive decline in the serum concentrations after administration of a dose on days 1, 4, and 8. Nine other patients begun on a similar schedule manifested gastrointestinal symptoms attributed to the clotrimazole and were unable to complete the study. Concentrations of active drug in the urine were less than 1 N of the administered dose.Systemic fungal infections contribute significantly to the morbidity and mortality of patients with hematological malignancies (1, 7) and of transplant patients receiving immunosuppressive therapy (13,17,20 (Fig. 1). Several reports indicate that this agent has broad in vitro antifungal activity against both pathogenic yeasts and filamentous fungi (10,12,16,23 phosphatase. There was an interval of at least 48 hr between studies in the same individuals, and all studies were done after an overnight fast. Single-dose studies were performed in seven normal volunteers and one cancer patient with doses of 1.5 and 3 g of clotrimazole. Serum specimens were collected immediately prior to each study and at 1, 2, 3, 4, and 6 hr after administration of the drug. Urine specimens were collected immediately prior to each study and for 6 hr after drug administration.To determine the effect of multiple dosing on serum levels, 15 cancer patients being treated for their disease in protected-environment units (2) were begun on clotrimazole, 1.5 g every 6 hr for 8 days. All of these patients were receiving prophylactic oral nonabsorbable antibacterial antibiotics (3) but no other antifungal agents during the period of study. The studies 423 Vol. 2,No. 6

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confidence: 99%

“…Systemic fungal infections contribute significantly to the morbidity and mortality of patients with hematological malignancies (1, 7) and of transplant patients receiving immunosuppressive therapy (13,17,20 (Fig. 1).…”

mentioning

confidence: 99%

Clotrimazole (Bay b 5097): In Vitro and Clinical Pharmacological Studies

Burgess

Bodey

1972

Antimicrob Agents Chemother

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“…All patients with aspergillosis from those three series of liver transplantations [2][3][4] [1,[7][8][9][10][11] has survived. Similar survival rates among heart transplant recipients and an occasional survivor of pulmonary disease have been reported, but none of such patients in whom the aspergillosis involved the CNS survived [12][13][14][15] .…”

Section: Discussionmentioning

confidence: 54%

“…Cases of invasive aspergillosis have been reported after transplantation of the liver [2][3][4][5][6], kidney [1,[7][8][9][10][11], and heart [12][13][14][15]. Aspergillosis was diagnosed in 9 % of adult liver transplant recipients who received immunosuppressive therapy consisting of administration of azathioprine, prednisone, and antilymphocyte globulin [2].…”

Section: Discussionmentioning

confidence: 99%

Aspergillosis of the CNS in a Pediatric Liver Transplant Recipient: Case Report and Review

Green¹,

Wald²,

Tzakis³

et al. 1991

Clinical Infectious Diseases

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“…Published series from several transplantations centers indicate that the major cause of late deaths following transplantation is caused by or associated with infection, and that in 33 to 74% the causative organisms are Candida and Aspergillus (10,16,18,25). After renal transplantation, most patients receive azathioprine (or similar immunosuppressive agents), and if signs of rejection occur, they are then treated with high doses of glucocorticoids (8).…”

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confidence: 99%

5-Fluorocytosine in the Treatment of Experimental Candidiasis in Immunosuppressed Mice

Linquist

Rabinovich

Smith

1973

Antimicrob Agents Chemother

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A model infection with Candida albicans was established in mice. The animals were pretreated for 1 week with azathioprine, given dexamethasone, and then infected intravenously with Candida . Mortality for the group given Candida infection alone was 20%, 38% when azathioprine was added, and 50% when dexamethasone and azathioprine were given with infection. The titers of Candida in most mice were 10 6 per gram of kidney. The rest of the mice were killed at 30 days. At this time, 16% had no evidence of Candida in the kidneys, but 40% of the mice had titers of 10 6 or more. Mice treated with 5-fluorocytosine had a mortality of less than 4% in 30 days. Five percent of the treated mice killed at 30 days had titers of Candida of 10 6 . Therefore, 5-fluorocytosine increases survival in the presence of continued therapy with azathioprine with or without pretreatment with dexamethasone. The survival is associated with decreased titers of Candida in the kidneys.

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Infectious Complications After Cardiac Transplantation in Man

Cited by 145 publications

References 27 publications

Clotrimazole (Bay b 5097): In Vitro and Clinical Pharmacological Studies

Clotrimazole (Bay b 5097): In Vitro and Clinical Pharmacological Studies

Aspergillosis of the CNS in a Pediatric Liver Transplant Recipient: Case Report and Review

5-Fluorocytosine in the Treatment of Experimental Candidiasis in Immunosuppressed Mice

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