Acute generalized exanthematous pustulosis due to ceftriaxone: Report of a pediatric case with recurrence after positive patch test

Acute generalized exanthematous pustulosis (AGEP) is seen uncommonly in children and sometimes shows atypical clinical features in this population. Patch testing can be used effectively in children for the confirmation of the culprit drug in cases of multiple drug use. Here, we report a rare, pediatric case of ceftriaxone‐induced AGEP confirmed by patch testing with subsequent recurrence of the skin eruption.     

Clinical and bacteriological outcomes in hospitalised patients with community-acquired pneumonia treated with azithromycin plus ceftriaxone, or ceftriaxone plus clarithromycin or erythromycin: a prospective, randomised, multicentre study

This study compared patients with moderate-to-severe community-acquired pneumonia (CAP) requiring hospitalisation, who received initial therapy with either intravenous ceftriaxone plus intravenous azithromycin, followed by step-down to oral azithromycin (n = 135), with patients who received intravenous ceftriaxone combined with either intravenous clarithromycin or erythromycin, followed by step-down to either oral clarithromycin or erythromycin (n = 143). Clinical and bacteriological outcomes were evaluated at the end of therapy (EOT; day 12-16) or at the end of study (EOS; day 28-35). At baseline, mean APACHE II scores were 13.3 and 12.6, respectively, with >50% of patients classified as Fine Pneumonia Severity Index (PSI) category IV or V. Clinical success rates (cure or improvement) in the modified intent-to-treat (MITT) population at EOT were 84.3% in the ceftriaxone/azithromycin group and 82.7% in the ceftriaxone/clarithromycin or erythromycin group. At EOS, MITT success rates (cure only) were 81.7% and 75.0%, respectively. Equivalent success rates in the clinically evaluable population were 83% and 87%, respectively, at EOT, and 79% and 78%, respectively, at EOS. MITT bacteriological eradication rates were 73.2% and 67.4%, respectively, at EOT, and 68.3% vs. 60.9%, respectively, at EOS. Mean length of hospital stay (LOS) was 10.7 and 12.6 days, and the mean duration of therapy was 9.5 and 10.5 days, respectively. The incidence of infusion-related adverse events was 16.3% and 25.2% (p 0.04), respectively. An intravenous-to-oral regimen of ceftriaxone/azithromycin was at least equivalent in efficacy and safety to the comparator regimen and appeared to be a suitable treatment option for hospitalised patients with CAP.     

Vilsmeir法合成头孢曲松钠的工艺研究

目的　探讨头孢曲松钠的Vilsmeir法合成工艺。方法　用二氯硫酰代替二氯亚硫酰来制备得到改进的Vilsmeir试剂 ,用vilsmeir试剂活化的氨噻肟乙酸同 7-ACT缩合反应制备头孢曲松钠。结果与讨论　Vilsmeir法合成工艺简单、便宜、收率达 85 %。     

市售注射用头孢曲松钠部分产品质量比较

 目的　对市售 7个厂家生产的17批注射用头孢曲松钠产品进行质量比较,为临床应用提供参考。方法　参考美国药典、英国药典、欧洲药典、中国药典和原开发厂标,选择临床有意义的指标进行比较,包括澄清度、颜色、吸收值、水分、pH值、不溶性微粒、含量、降解产物或相关物质、聚合物、装量差异、有机溶剂残留量和西林瓶外壁残留等 12个方面。结果　按照中国药典的要求 ,所测各厂市售产品均合格。但如依更严格的标准来衡量则可发现差异。结论　不同厂家的产品确实存在一定的差异。     

非淋菌性尿道炎合并盆腔感染药物治疗效果对比研究

目的探讨临床上对非淋菌性尿道(宫颈)炎合并盆腔感染有效的治疗方法。方法将妇产科及性病科门诊确诊的非淋菌性尿道(宫颈)炎合并盆腔感染201例病人随机分为2组,治疗组采用头孢曲松纳加阿奇霉素治疗,对照组采用头孢曲松纳加口服美满霉素治疗。结果治疗组治愈率为80.95%,总有效率为97.14%;对照组治愈率为58.33%,总有效率为69.79%。两者的,临床治愈率及有效率有显著性的差异(P<0.005)。结论头孢曲松纳加阿奇霉素静脉给药治疗非淋菌性尿道(宫颈)炎合并盆腔感染取得良好的治疗效果,较头孢曲松纳加美满霉素效果有显著性提高。     

In-vitro activity of ceftriaxone combined with newer agents against MRSA

In this study, in vitro synergism in combinations of agents as ceftriaxone/dalbavancin, ceftriaxone/linezolid and ceftriaxone/daptomycin against MRSA strains were investigated. Thirty clinical MRSA strains were tested. The minimum inhibitory concentrations of all antibiotics were determined using reference broth microdilution method. In-vitro activities of antibiotics combined against the strains were tested using two-dimensional checkerboard microdilution method. Results were interpreted as follows: synergy = FICI ≤0.5; ‘no interaction’ effect = FICI ?0.5-≤4; antagonism = FICI ?4. The MIC₅₀, MIC₉₀ and MIC_range of ceftriaxone, daptomycin, dalbavancin and linezolid were found as 128, 1024 and 16-2048 mg/L; 1, 1 and 0.5–1 mg/L; 0.12, 0.12 and 0.03–0.12 mg/L; and 1, 2 and 1–2 mg/L, respectively. Our results showed that the frequency of synergistic effects (FICI: ≤0.5) of three combinations were all at the same rate of 77% (23/30). No in vitro antagonism (FICI >4) was observed.     

某炼油厂466名苯作业工人职业健康状况分析

目的　探讨头孢曲松钠联合阿立哌唑对神经梅毒患者的临床治疗效果。方法　选取2014年1月—2019年2月淄博市第一医院收治的78例神经梅毒患者作为研究对象，按照随机数字表法分为对照组（n=39）和观察组（n=39）。对照组采用青霉素联合阿立哌唑治疗，观察组采用头孢曲松钠联合阿立哌唑治疗，并完成4周治疗及12个月随访。比较2组阳性与阴性症状量表（positive and negative syndrome scale, PANSS）评分、临床疗效总评量表病情严重程度（clinical global impression- severity of illness, CGI-SI）评分、T细胞百分比、细胞因子水平、不良反应及复发情况。结果　观察组治疗后4周阴性症状评分、阳性症状评分、一般精神病理症状评分及PANSS总分下降幅度均大于对照组（P均＜0.05）；观察组治疗后4周CD3+ T细胞、CD4+ T细胞、CD4+/CD8+ T细胞 、IL-2、IL-12水平上升幅度均高于对照组（P均＜0.05）；观察组治疗后1、2、3、4周CGI-SI评分均低于对照组（P均＜0.05）；观察组治疗后6个月、12个月复发率均低于对照组（P均＜0.05）。结论　头孢曲松钠在治疗神经梅毒患者中，能改善患者神经症状，降低患者临床症状评分，提高患者T细胞百分比，改善细胞因子水平，降低治疗后复发率，药物安全性较高，值得推广应用。     

52例头孢曲松钠不良反应分析

目的：探讨头孢曲松钠不良反应发生的特点及相关因素,为临床合理用药提供参考。方法：采用回顾性研究方法,对上海交通大学附属第一人民医院2006年1月-2012年12月上报的因使用头孢曲松钠出现的52例不良反应报告进行统计和分析。结果：头孢曲松钠所致不良反应主要为皮肤及附件损害（33例,63.5%）和过敏性休克（5例,9.6%）。结论：应加强对头孢曲松钠不良反应的监测,注意其过敏性休克等严重不良反应,保障用药安全。