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Biomedical subjects

A M Geddes

Publications and source records attributed to A M Geddes.

149 records · Page 9Linked to original sources
PubMedDate not supplied

Imipenem/cilastatin in the treatment of serious bacterial infections.

Imipenem (N-formimidoyl thienamycin) is a new carbapenem beta-lactam antibiotic with a broad antibacterial spectrum. Forty-five patients were treated with either 500 or 1,000 mg of imipenem/cilastatin four times daily, the duration varying according to clinical response. The diagnoses were urinary tract infection, 10 patients; septicemia, six; intraabdominal sepsis, six; pneumonia, six (two cases of Legionnaires' disease); skin and soft tissue infection, four; and other diagnoses, 13. Of the 32 clinically assessable patients, 17 were cured, nine improved, three died, and three were withdrawn from the trial. Of 21 patients who were microbiologically assessable, 13 were cured. In six cases of complicated urinary tract infection, the organism--which had been eradicated from the urine during treatment--reappeared after completion of antibiotic therapy. Two patients developed adverse clinical reactions that were thought to be drug-related (drug-induced fever and nausea plus vomiting, respectively). Both patients had mildly abnormal results in liver function tests, and one developed a positive direct Coombs' test. Fifty-seven percent of the patients developed some degree of phlebitis, which was moderate to severe in 19%. In this study imipenem/cilastatin proved to be a highly effective agent for the treatment of a variety of serious bacterial infections.

Adolescent↗
PubMedDate not supplied

Studies of beta-lactam antibiotics in systemic infections: some personal observations over 25 years.

In this paper the problems associated with clinical trials of beta-lactam antibiotics based on 25 years of personal experience are discussed. Clinical trials in patients with uncomplicated urinary tract infections are relatively simple to conduct, but the interpretation of trials in patients with life-threatening infections such as endocarditis can be extremely difficult. Open, noncontrolled studies are necessary for the initial evaluation of an antibiotic, but comparative trials with other agents are essential for determining the indications for the use of new chemotherapeutic agents in the treatment of specific infections. Clinical evaluation of new antimicrobial agents must include pharmacologic and toxicologic studies, and trial protocols should be designed so as to obtain as much information as is practical about the absorption, distribution, and excretion of antibiotics in patients and also to determine the incidence and nature of adverse reactions. The problems associated with undertaking clinical trials in specific infections are discussed.

Animals↗