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Adverse drug reactions are one of the leading causes of death in the world. They are also responsible for an increase in hospital admissions and higher care costs. Among the most associated drugs with these reactions are antibiotics and of these the most common are beta-lactams, which are widely used in health institutions. The most frequent manifestations of adverse reactions to beta-lactams are allergic, dermatological, gastrointestinal, renal, hepatic and neurological reactions. A general review of the adverse reactions to these drugs is carried out. Also, the different beta-lactam antibiotics are described along with their classification and spectrum of action, and an accurate explanation of the different adverse reactions due to the use of beta-lactams according to the compromised system is made. [ABSTRACT FROM AUTHOR]

The Formation of an abscess in the pleural space that spreads through the adjacent tissues is known as Empyema Necessitatis, which is a rare complication, even more if it is secondary to trauma. An early management is vital and consists of a surgical drainage of empyema associated with broad-spectrum antibiotics until the etiologic agent is identified. Mycobacterium tuberculosis is the most common etiology found. The article presents a report on a medical case of a 47 year-old patient without a significant personal medical history, who was initially admitted for polytrauma due to a fall from his own height. The trauma was treated in a conventional way. After 15 days, is admitted again with fever and a new mass in the wall chest. A CT tomography showed a pus fistulation from the pleural space through the soft tissues of the chest. A drainage was performed and broad-spectrum antibiotics were given until sensitive Staphylococcus aureus was identified. Finally, the patient got better and continued ambulatory management. [ABSTRACT FROM AUTHOR]

Objective: Febrile neutropenia is a condition present in patients with some degree of immunosuppression associated to oncology treatment, which leads to risks of infectious complications and death. The aim of this research is to describe the clinical, microbiological and prognostic characteristics in patients with febrile neutropenia in a university hospital. Methodology: Retrospective cohort study developed between January of 2012 and June of 2016 in patients with febrile neutropenia (neutrophils <500 cell/mm, temperature >38.3 °C), who were hospitalized in the Pablo Tobon Uribe Hospital of Medellin, Colombia. Results: 226 patients were evaluated, 96% of who had an oncological diagnostic. The main infectious sources were the skin and the gastrointestinal tract. Blood cultures were positive in 31%. The main pathogen was Escherichia coli in 26% and the overall hospital mortality rate was 17%. Conclusions: The clinical characteristics of our population were similar to the national and international reports, but we found epidemiological differences in microbiological agents, bacterial resistance and mortality. Only one third of the patients presented bacteremia. E. coli remains the main pathogen involved. [ABSTRACT FROM AUTHOR]

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a potentially fatal cutaneous reaction to drugs, which has an unclear pathogenesis. It is commonly associated with fever, lymphadenopathy, visceral involvement, and hematologic disorders including eosinophilia. Herein, we present the case of a 22-year-old man who had been receiving antibiotics and analgesics for a respiratory infection, and developed an exanthem that spread throughout most of the body, fever, altered liver, and kidney tests. The skin biopsy was consistent with a drug reaction. The patient notably improved after discontinuation of the offending drugs and corticosteroid treatment. Prompt diagnosis through clinical and laboratory criteria is crucial given the multisystemic and potentially fatal nature of this disease. [ABSTRACT FROM AUTHOR]

Objective: To describe the clinical and demographical characteristics of patients with osteomyelitis due to Candida spp. in Hospital Pablo Tobón Uribe in Medellín. Methodology: Observational, descriptive study. Results: Thirty patients were found to have osteomyelitis due to Candida spp. Of these, 70% were male, with a mean age of 49.9 years. 46% had a history of some type of immunosuppression; 60% had osteomyelitis due to Candida spp. where it was the only microorganism isolated and 40% had concomitant bacterial osteomyelitis. One patient had candidemia. 46% had previously undergone surgery and 26% had had some type of osteosynthesis material. Twenty-six patients (86%) had previously received antibiotics, where carbapenems, piperacillin, tazobactam, and vancomycin were the most frequently used. The long bones were the most affected osseous segments (33%). Non-albicans Candida was 63% and Candida spp. 3.3%. The most frequent of non-albicans Candida was Candida parapsilosis in 57%. 97% of isolations were sensitive to fluconazole and voriconazole. 46% finished treatment. Follow-up data were not collected from 43%, while 6.6% did not finish treatment. Conclusions: As osteomyelitis due to Candida is increasing, analytic studies are warranted to explore associated risk factors. There was also an increase in non-albicans Candida compared to that which has been described in the literature, and only one case was found to have intermediate sensitivity to fluconazole. [ABSTRACT FROM AUTHOR]

Objective: To determine the adequate frequency of empirical antibiotic treatment in an intensive care unit in Colombia. Methodology: Observational, analytic study. Data was collected from the clinical and microbiological history of the intensive care unit (ICU) at Clinica de Tunja. Data was collected from the empirical antibiotic regimen, antibiograms, and percentage of adjustment according to culture results. The percentage of adequate empirical therapy was determined based on the cultures and antibiograms. Results: We studied 198 cases of infection in ICU between July 2008 and September 2011. Seventy-five percent of infections was documented by microbiological media, which corresponds to 148 patients with 165 microorganisms. In 94 of 148 patients with infection documented by cultures, empirical treatment was adequate (64%). In cases of infection not documented by cultures, empirical therapy was adequate in 36 of 50 patients (72%). In 128 (65%) of cases, empirical treatment was changed. Empirical treatment was adequate in 100% of cases that received imipenem, piperacillin/tazobactam and amikacin, compared to 68% when imipenem/amikacin was used (p <0.001) and 29% when only imipenem was used (p <0.001). Conclusions: The percentage of adequate empirical therapy was low (65.6%) and increased with the combination of three antimicrobials in populations with high probability of infection by multi-resistant germs. [ABSTRACT FROM AUTHOR]