Search PubMed⌕ Search

Biomedical subjects

B E Scully

Publications and source records attributed to B E Scully.

33 records · Page 2Linked to original sources
PubMed1985

The pharmacokinetic and bactericidal characteristics of oral cefixime.

The pharmacokinetics of cefixime (FK 027), a broad-spectrum cephalosporin, were assessed in 12 normal subjects after single oral doses of 50, 100, 200, and 400 mg. Mean peak serum concentrations were 1.02, 1.46, 2.63, and 3.85 micrograms/ml after the four respective doses. Respective mean serum levels at 12 hours were 0.16, 0.33, 0.72, and 1.13 micrograms/ml. Volumes of distribution averaged 0.1 L/kg body weight, and the elimination t1/2 was 3 hours for all doses. The AUC was 7.01, 11.4, 22.5, and 36.4 micrograms X hr/ml for the four doses, respectively. Serum clearance averaged 0.4 mg/min/kg and mean 24-hour urinary recovery was 21%, 19%, 20%, and 16% for the four respective doses. Serum bactericidal titers at 4 hours exceeded 1:16 for Streptococcus pneumoniae, S. pyogenes, Hemophilus influenzae, and Branhamella catarrhalis. Urine bactericidal titers exceeded 1:8 for Escherichia coli, Klebsiella pneumoniae, and Enterobacter cloacae resistant to the available oral cephalosporins.

Administration, Oral↗
PubMed1985

The pharmacology of orally administered ciprofloxacin.

Ciprofloxacin pharmacokinetics were studied in 6 volunteers after 250 and 500 mg single oral doses. Mean peak serum levels were 1.45 micrograms/ml and 2.5 micrograms/ml for 250 and 500 mg doses. The 12-h levels were 0.12 micrograms and 0.22 micrograms. T1/2 alpha values were 0.32 and 0.43 h; T1/2 beta was 4 h and Vd (area) values were 80L and 90L for the two doses respectively. AUC was 5.65 h. micrograms/ml and 10.37 h. micrograms/ml. Serum clearance was 23L for both doses. Approximately 49% of the 250 mg dose and 43% of the 500 mg dose was recovered in the urine. Ciprofloxacin's in vitro activity and human pharmacology should permit a twice or once-daily dosing schedule for systemic infections due to most Enterobacteriaceae, Haemophilus, Branhamella and Pseudomonas and S. aureus, and once-daily doses for urinary and gastrointestinal infections.

Administration, Oral↗
PubMed1984

Ceftriaxone in the treatment of serious infections, particularly after surgery.

The clinical efficacy and safety of ceftriaxone when administered twice daily was evaluated in the treatment of serious infections, including 9 episodes of bacteremia, 4 of pneumonia, 7 of intra-abdominal or soft tissue infections, 11 of urinary tract infections, 3 of osteomyelitis, and 5 of meningitis. Causative pathogens were Strep. pneumoniae, other hemolytic streptococci, E. coli, P. mirabilis, K. pneumoniae, and species of Enterobacter, Serratia, and Pseudomonas. The overall clinical cure rate was 87 percent and the bacteriologic cure rate was 77 percent. Cures were achieved in infections due to organisms resistant to ampicillin, cefazolin, cefamandole, carbenicillin, and gentamicin. Peak plasma levels were far in excess of the minimal inhibitory concentrations of Enterobacteriaceae. Adverse effects were infrequent, and in only one instance was it necessary to discontinue treatment. Resistance to ceftriaxone developed during therapy with several Enterobacter and Pseudomonas species isolates. Ceftriaxone appears to be a useful agent for treatment of serious gram-negative infections in seriously ill patients.

Abdomen↗
PubMed1984

Pharmacokinetics of ceftriaxone after intravenous infusion and intramuscular injection.

The pharmacokinetics of ceftriaxone were evaluated in eight adults after doses of 1 g administered by intravenous infusion and 1 and 0.5 g administered by intramuscular injection. Mean peak plasma concentrations were 168 micrograms/ml for 1 g given intravenously, 81 micrograms/ml for 1 g given intramuscularly, and 46 micrograms/ml for 0.5 g intramuscularly. Plasma concentrations were similar by both high pressure liquid chromatographic and microbiologic methods. The plasma half-lives were 7.6 and 8.3 hours, respectively, for the intravenous infusion and intramuscular injection. Plasma concentrations were equal for the 1 g intravenous and intramuscular routes by 2.5 hours. Plasma concentrations exceeded the minimal inhibitory concentrations (MICs) of most aerobic gram-positive and gram-negative organisms with the exception of Pseudomonas aeruginosa and Acinetobacter species for 24 hours. Urinary concentrations exceeded 100 micrograms/ml for 24 hours for the 1-g doses and for 12 hours for the 0.5-g dose. Urinary recovery of ceftriaxone within 24 hours was 40 percent for intravenous infusion and 33 and 34 percent for the intramuscular injection. A single 1-g dose daily will exceed the MICs of most staphylococcal and streptococcal species and Enterobacteriaceae for 12 to 24 hours.

Adult↗
PubMed1984

Clinical efficacy of ceftazidime. Treatment of serious infection due to multiresistant Pseudomonas and other gram-negative bacteria.

Ceftazidime, a beta-lactamase stable cephalosporin, was administered to 57 patients. Substantial underlying disease was present in the majority of patients, and 50% were in critical or poor condition. Ceftazidime inhibited all initial isolates of Enterobacteriaceae at 8 mg/L or less, regardless of resistance to other antibiotics and the majority of Pseudomonas aeruginosa at 12 mg/L or less. The mean serum level after infusion of 1 g during 30 minutes was 62 mg/L. Overall clinical response was 84%, and the bacteriological response was 72% excluding cystic fibrosis patients. No major adverse effects were encountered. Resistance developed in Pseudomonas from patients with cystic fibrosis and in Enterobacter from two other patients. Ceftazidime was an effective, safe therapy for serious infection due to multiply resistant Pseudomonas and other aerobic gram-negative bacilli including aminoglycoside-resistant Serratia and Klebsiella.

Acute Disease↗
PubMed1984

The pharmacology of clavulanic acid and ticarcillin combined.

The pharmacokinetics of ticarcillin and clavulanic acid were studied in normal volunteers. Ticarcillin at 50 mg/kg was combined with clavulanic acid at 1.7 and 3.4 mg/kg and infused over 30 minutes. Peak serum levels of ticarcillin were 325 micrograms/ml and its pharmacokinetic parameters were similar when combined with either dose of clavulanic acid. Peak serum levels of clavulanic acid were 8 micrograms/ml for 1.7 mg/kg and 15.8 micrograms/ml for 3.4 mg/kg. Serum concentrations of clavulanic acid were greater than or equal to 1 microgram/ml for 2 h with the 1.7 mg/kg dose and for 3 h with the 3.4 mg/kg dose. Serum half-lives of ticarcillin and clavulanic acid were similar, 1.2 hours. Urinary concentrations of ticarcillin exceeded 100 micrograms/ml and clavulanic acid concentrations exceeded 1 microgram/ml for 6 h. The serum and urine levels were such that many beta-lactamase producing organisms would be inhibited by this combination.

Adult↗
PubMed1983

In vitro activity and beta-lactamase stability of cefodizime, an aminothiazolyl iminomethoxy cephalosporin.

Cefodizime, an iminomethoxy aminothiazolyl cephalosporin similar to moxalactam and ceftazidime, was less active (minimal inhibitory concentration, 1.6 to 12 micrograms) than cefazolin or cefotaxime against Staphylococcus aureus and Staphylococcus epidermidis. It inhibited Haemophilus and Neisseria spp. at less than 0.5 microgram/ml. It did not inhibit methicillin-resistant staphylococci, enterococci, or Listeria spp. and was 8- to 32-fold less active than cefotaxime, moxalactam, or ceftazidime against Escherichia coli, Citrobacter spp., Klebsiella pneumoniae, Providencia spp., and Serratia spp. Cefotaxime-resistant Enterobacter cloacae, Citrobacter freundii, and Proteus vulgaris were resistant to cefodizime. Cefodizime was less active than cefoxitin or moxalactam against Bacteroides fragilis. Cefodizime was not hydrolyzed by common plasmid or chromosomal beta-lactamases, and it inhibited type I beta-lactamases.

Bacteria↗
PubMed1983

Pharmacology of aztreonam after intravenous infusion.

The pharmacokinetics of aztreonam, a monocyclic beta-lactam which inhibits most members of the family Enterobacteriaceae at concentrations of less than 1 microgram/ml and most Pseudomonas aeruginosa isolates at concentrations of less than 16 micrograms/ml, were examined in healthy male volunteers after 30-min intravenous infusions of 0.5, 1, and 2 g of the drug. Mean peak levels of the drug in serum at the end of infusion were 65.5, 164, 255 micrograms/ml after 0.5 1, and 2 g, respectively, with levels of the drug in serum of 1.8, 3, and 8.5 micrograms/ml at 8.5 h for the three doses, respectively. The half-life was approximately 2 h for all three doses. The total serum clearance averaged 1 ml/min per kg. The apparent volume of distribution averaged 0.17 liter/kg for the three doses. Overall excretion of the drug in urine was 61%, with mean levels in urine of 23, 52, and 109 micrograms/ml at 8.5 to 12.5 h after 0.5, 1, and 2 g of aztreonam, respectively. Concentrations of the drug in serum after a 1-g dose exceeded the minimal inhibitory concentration for 90% of the members of the Enterobacteriaceae by four- to eightfold for 8 h and exceeded the minimal inhibitory concentration for P. aeruginosa isolates for 4 h.

Adult↗
PubMedDate not supplied

Streptococcus agalactiae (group B) endocarditis--a description of twelve cases and review of the literature.

The group B streptococcus has been shown to be a major cause of meningitis in the newborn and an occasional cause of endocarditis and sepsis in postpartum women. Little attention has been devoted to this organism as a cause of bacterial endocarditis. Twelve patients with group B streptococcal endocarditis were seen at The Presbyterian Hospital, New York, NY, between 1974 and 1985. There were seven women, five men. Ages ranged from 32 to 81 years. Serious underlying disease was present in all - diabetes mellitus in seven, carcinoma in three (bladder in two, and breast in one), alcoholism in three, malnutrition in two, heroin addiction in one, tuberculosis in one, serious prior valvular heart disease in two. The aortic valve was affected in four patients - mitral in two, mitral and aortic in one, tricuspid in four, unknown in one. The presentation was acute in seven patients. Metastatic infection occurred in seven, heart failure in six, major emboli in four, septic pericarditis in one, myocardial abscess in one. The group B streptococcus should be considered as a pathogen capable of causing acute endocarditis in certain patients with defects of host defense, particularly patients with diabetes mellitus, carcinoma or alcoholism. Cardiac surgery may be necessary in these patients due to the rapid destruction of the valves which occurs, in spite of the fact that the organisms are usually highly susceptible to penicillin.

Adult↗
PubMedDate not supplied

The use of cefepime (BMY 28142) to treat respiratory infections.

Cefepime, an aminothiazolyl cephalosporin active against Gram-positive and Gram-negative bacteria, was used at a dose of 1 g every 12 hours to treat respiratory and other infections in 29 patients. All 19 patients from whom an organism was cultured responded clinically and microbiologically. The patients had underlying risk factors of human immune virus positive status, 58%, and chronic lung disease, 19%. Cefepime was well tolerated. Organisms eradicated included Streptococcus pneumoniae and Haemophilus influenzae. Further study will define cefepime's role in hospital-acquired respiratory infection.

Adult↗
PubMedDate not supplied

Oral ofloxacin therapy of infections due to multiply-resistant bacteria.

We determined the efficacy and safety of orally administered ofloxacin, 400 mg twice daily, in the treatment of infections due to multiply-resistant bacteria. Patients (n = 99) were treated for 84 infections in 82 patients evaluable for efficacy with a bacteriologic response of 71%. Organisms treated included Pseudomonas aeruginosa (39), Staphylococcus aureus (11), Serratia marcescens (9), Enterobacter species (7), five each of Escherichia coli, Citrobacter, Salmonella, Klebsiella, and other organisms. The overall clinical responses was 89%: 28 (90%) of 16 osteomyelitis, 10 (83%) of 12 urinary tract infections, and three of three bacteremias. Insomnia occurred in 27% and responded to dose reduction. Resistance of P. aeruginosa to ofloxacin developed in 15% of isolates. No hepatic, renal, or hematologic toxicity developed in spite of long therapy, 283 days. Ofloxacin was an effective therapy for lower respiratory, urinary, bone, and soft tissue infections due to multiply-resistant Gram-negative bacteria and is effective for selected Staphylococcus aureus infections.

Administration, Oral↗
PubMedDate not supplied

Activity of cefsulodin and other agents against Pseudomonas aeruginosa.

Cefsulodin is a novel cephalosporin that contains a pyridinomethyl substituent at position 3 of the dihydrothiazine ring and a sulfo group on the acyl side chain. Cefsulodin has a high affinity for penicillin-binding proteins of Pseudomonas aeruginosa but binds poorly to those of other bacteria. Cefsulodin has the ability to readily pass through the outer wall of P. aeruginosa and is poorly hydrolyzed by most chromosomal beta-lactamases. It is partially destroyed by the carbenicillinases of P. aeruginosa that are plasmid mediated. Cefsulodin inhibits 50% of P. aeruginosa isolates at concentrations of 2-4 micrograms/ml. Cefsulodin acts synergistically with all aminoglycosides against 20%-80% of P. aeruginosa isolates.

Aminoglycosides↗
PubMedDate not supplied

Treatment of lower respiratory tract infections due to Pseudomonas aeruginosa in patients with cystic fibrosis.

Twelve patients who underwent 26 episodes of lower respiratory tract infection due to Pseudomonas aeruginosa were treated with aztreonam. Infectious episodes were severe in 11 patients, moderate in 10 patients, and mild in five patients. In 85% of the episodes, significant clinical improvement occurred, but in four severe episodes, the clinical response was unsatisfactory. The mean interval between initiation of treatment and improvement was seven days. Aztreonam was as clinically effective in the treatment of infections due to organisms susceptible to penicillins active against Pseudomonas as it was in the treatment of infections due to organisms resistant to these agents. P. aeruginosa was not permanently eradicated from the sputum of any of the patients treated with aztreonam. It did not cause any major adverse effects, and the only laboratory abnormality found was an increase in alkaline phosphatase, which occurred during 12 (46%) courses of therapy. Levels of alkaline phosphatase returned to normal after conclusion of treatment. Aztreonam was shown to be clinically effective in the treatment of lower respiratory infections due to P. aeruginosa in patients with cystic fibrosis.

Adolescent↗
PubMedDate not supplied

Clinical experience with aztreonam in the treatment of gram-negative bacteremia.

Aztreonam was used for the treatment of gram-negative bacteremia in 101 patients. In 34 instances a second antibiotic was prescribed for the treatment of suspected or documented gram-positive or anaerobic infection. The sources of bacteremia were the urinary tract (50 patients), an intraabdominal site (17), the respiratory tract (8), an intravascular site (9), and an unknown site (17). The clinical response rate was 92% (91 of 99 patients). The bacteriologic response rate was 97% (98 of 101 patients). In six of seven patients, Pseudomonas aeruginosa bacteremia was cured. Twelve patients developed superinfection with gram-positive cocci or Candida, and one patient developed diarrhea associated with Clostridium difficile. No other serious toxic effects were noted.

Adolescent↗