Clinical Microbiology and Antimicrobial Chemotherapy
Volume 5, No 1, 2003

Diseases and Pathogens

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Genital Herpes: Recent Problems and Their Solution

V.A. Akovbyan, S.A. Masyukova, E.V. Vladimirova, A.B. Zudin, S.B. Pokrovskaya

Genital herpes (GH) is widely distributed sexually transmitted disease that is caused by herpes simplex virus type 1 nd 2. This article presents the questions of epidemiology and pathogenesis of this infection. Clinical features and major criteria for diagnosis of GH are described in detail. Special attention is paid to the questions of specific antiviral therapy of GH, such as treatment of primary GH, episodic antiviral therapy, prophylactic use of antiviral agents. Perspectives of therapy and prophylaxis of GH, including specific antivirals as well as vaccines and immunomodulatory agents are also discussed.

Key words: genital herpes, epidemiology, treatment, prophylaxis.

Antimicrobials

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Moxifloxacin: the Present and the Future in the Sequential Therapy

L.S. Stratchounski, A.V. Veselov, V.A. Kretchikov

Institute of Antimicrobial Chemotherapy, Smolensk, Russia

Moxifloxacin is a new broad spectrum 8-methoxiquinolon with high activity against both Gram(+) and Gram(-) microorganisms as well as against anaerobes and intracellular pathogens. It is also active against microorganisms that are resistant to other classes of antimicrobials, including penicillin- and macrolide-resistant pneumococci and β-lactamase-producing Haemophilus influenzae.

An excellent activity against the above mentioned pathogens and good pharmacokinetic profile allows to use moxifloxacin for monotherapy of respiratory tract infections. High clinical efficacy and safety of moxifloxacin has been demonstrated in treatment with sequential therapy of community-acquired pneumonia in the controlled clinical trials.

The literature review of clinical trials on sequential (IV/PO) moxifloxacin therapy in patients with community-acquired pneumonia is presented in the article. An attempt to analyse the perspectives of further moxifloxacin usage is made.

Key words: moxifloxacin, fluoroquinolones, pneumonia, sequential therapy.

ABC of New Antimicrobials

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Caspofungin – The First Antifungal Drug of the Echinocandins Group

Antimicrobial Resistance

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Comparative Activity of Antipseudomonal Antibiotics Against Nosocomial Strains of P.aeruginosa in Russian ICUs

L.S. Stratchounski, G.K. Reshedko, O.U, Stetsiouk, A.S. Andreeva, A.G. Tschebnikov, and ROSNET Study Group

Institute of Antimicrobial Chemotherapy, Smolensk, Russia

In vitro susceptibility study of nosocomial strains of Pseudomonas aeruginosa isolated from patients with nosocomial infections in 21 Russian ICUs was performed. Antibiotics with antipseudomonal activity, such as piperacillin, piperacillin/tazobactam, ceftazidime, imipenem, meropenem, gentamicin, amikacin, ciprofloxacin were tested. The most active against tested P.aeruginosa isolates were meropenem, amikacin, ceftazidime. Rates of non-susceptibility to these antimicrobial agents were 3,0, 6,3 and 12,2%, respectively. The less active antibiotics were imipenem and ciprofloxacin, to which rates of non-susceptibility were 22,9 and 32,8, respectively. The least active antipseudomonal drug was gentamicin; 73,9% of tested P.aeruginosa isolates were non-susceptible. In this study, rates of non-susceptibility of P.aeruginosa to piperacillin and piperacillin/tazobactam were 56,5 and 37,7%, respectively.

Key words: Pseudomonas aeruginosa, nosocomial infections, antimicrobial resistance, meropenem, amikacin, ceftazidime.

Guidelines

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Practice Guidelines for the Antimicrobial Therapy in Neutropenic Patients with Cancer

(According to the Guidelines of Infectious Diseases Society of America)

G.A. Klyasova

Hematologic Research Center, Russian Academy of Medical Science, Moscow, Russia

Febrile neutropenia is becoming significant problem in Russian medical institutions. Changes in spectrum of causative pathogens, increase of the number of neutropenic patients and emergence of antimicrobial resistance - all the above factors require not only special attention of clinicians but also to the development of adequate practice guidelines. In our opinion at the moment the most valid guidelines for the therapy in febrile neutropenia is the recent guidelines of the Infectious Diseases Society of America (IDSA), so, in present article we try to adopt the above guidelines for the Russia.

This article presents approach to the diagnostics and the risk stratification in patients with neutropenia. Empiric choice of antimicrobials is also considered. Antibacterial therapy of febrile neutropenia is described in detail. Practice guidelines for efficacy evaluation of treatment, its modifications and duration are given. Use of antiviral agents, colony-stimulating factors and granulocyte transfusion are considered. Antibiotic and antifungal prophylaxis for neutropenic patients is presented as well.

Key words: febrile neutropenia, neutropenia, antibiotics, antimicrobial therapy.

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Guideline for Prevention of Surgical Site Infection

A.J. Mangram, T.C. Horan, M.L. Pearson, L.C. Silver, W.R. Jarvis

Hospital Infection Control Practices Advisory Committee (HICPAC)