采用‘免疫复合物’法检出两例抗-氧哌嗪青霉素相关的免疫性溶血性贫血

背景及目的 血清含有针对氧哌嗪青霉素和氧哌嗪青霉素相关类药物抗体的血清,通常被认为是药物包被红细胞(RBCs)(药物吸附法)起反应,但是在同样含有药物及RBCs试管中加入血清(‘免疫复合物’法)则不起反应,作者曾报道过两例由抗一氧派嗪青霉素导致的免疫性溶血性贫血。仅在一例患者中获得血清学详细资料。在该例中,抗体类型是Ig M+IgG,同时与吸附的药物及‘免疫复合物’法中起反应。材料及方法 二例囊性纤维化患者在氧派嗪青霉素治疗11—12天后,直接抗球蛋白测试(DATs)阳性,并且发生溶血性贫血。

Empirical antibiotic treatment with piperacillin-tazobactam in Patients with microbiologically-documented biliary tract infections

AIM: To report our experience with empiric antimicrobial monotherapy (piperacillin/tazobactam, of which no data are available in such specific circumstances) in microbiologically-documented infections in patients with benign and malignant conditions of the biliary tract.METHODS: Twenty-three patients, 10 with benign and 13 with malignant conditions affecting the biliary tree and microbiologically-documented infections were recruited and the efficacy of empirical antibiotic therapy was assessed.RESULTS: The two groups featured similar demographic and clinical data. Overall, the infective episodes were most due to Gram negative agents, more than 60% of such episodes (mostly in malignant conditions) were preceded by invasive instrumental maneuvers. Empirical antibiotic therapy with a single agent (piperacillin/tazobactam) was effective in more than 80% of cases. No deaths were reported following infections. CONCLUSION: An empiric therapeutic approach with piperacillin/tazobactam is highly effective in biliary tract infections due to benign or malignant conditions.