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B Slocombe

Publications and source records attributed to B Slocombe.

At least 19 recordsLinked to original sources

Activity of amoxicillin-clavulanate against penicillin-resistant Streptococcus pneumoniae in an experimental respiratory infection model in rats.

High doses of amoxicillin, equivalent to those produced by 500- and 750-mg oral doses in humans (area under the plasma concentration-time curve), were effective against a penicillin-resistant strain of Streptococcus pneumoniae in an experimental respiratory tract infection in immunocompromised rats; this superior activity confirms the results of previous studies. An unexpected enhancement of amoxicillin's antibacterial activity in vivo against penicillin-resistant and -susceptible S. pneumoniae strains was observed when subtherapeutic doses of amoxicillin were coadministered with the beta-lactamase inhibitor potassium clavulanate. The reason for this enhancement was unclear since these organisms do not produce beta-lactamase. The differential binding of clavulanic acid and amoxicillin to penicillin-binding proteins may have contributed to the observed effects.

Amoxicillin-Potassium Clavulanate Combination↗

High-level mupirocin resistance in Staphylococcus aureus: evidence for two distinct isoleucyl-tRNA synthetases.

Mupirocin resistance in Staphylococcus aureus results from changes in the target enzyme, isoleucyl-tRNA synthetase (IRS). Twelve strains of S. aureus comprising four susceptible (MICs < or = 4 micrograms/ml), four intermediate level-resistant (MICs between 8 and 256 micrograms/ml), and four highly resistant (MICs > or = 512 micrograms/ml) isolates were examined for their IRS content and the presence of a gene known to encode high-level mupirocin resistance. Ion-exchange chromatography of cell extracts showed a single IRS active peak in mupirocin-susceptible strains, with 50% inhibitory concentrations (IC50s) of 0.7 to 3.0 ng of mupirocin per ml. In strains showing intermediate mupirocin resistance, similar single IRS activity peaks were observed, but these were less sensitive to inhibition, and the mupirocin IC50s for them were 19 to 43 ng/ml. Strains that were highly resistant to mupirocin displayed two distinct peaks; one was similar to that found with susceptible strains (IC50, 0.9 to 2.5 ng/ml), but an additional peak with an IC50 of 7,000 to 10,000 ng/ml was also observed. A strain cured of the plasmid encoding high-level mupirocin resistance lacked the resistant IRS peak. Restriction digests, produced by endonuclease NcoI, of total bacterial DNA isolated from the highly resistant strains hybridized with a mupirocin resistance gene probe, whereas DNA isolated from the intermediate level-resistant and susceptible strains did not. These results demonstrate that two different IRS enzymes were present in highly mupirocin-resistant S. aureus strains. In strains expressing intermediate levels of resistance, only a chromosomally encoded IRS which was inhibited less by mupirocin than IRS from fully susceptible strains was detected.

Base Sequence↗

The antimicrobial activity of mupirocin--an update on resistance.

Mupirocin (pseudomonic acid A) has a novel chemical structure that is unrelated to any other known class of antibiotic, and possesses a unique mode of action. As a consequence, mupirocin lacks cross-resistance with other antibacterial agents and exhibits activity against strains of bacteria that are multiresistant. The selection in vitro of resistant variants of Staphylococcus aureus is slow, which is reflected in the low incidence of mupirocin resistance encountered in clinical practice. Pulse field gel electrophoresis studies on S. aureus highly resistant to mupirocin, have confirmed the presence of a large plasmid in the majority, but not all, of the isolates. Restriction endonuclease digests of the large plasmid DNA, and DNA hybridization studies with a non-radiolabelled probe constructed from total plasmid DNA, have shown that there were marked differences in plasmid types between isolates from different locations, but general similarities between plasmid types isolated from the same location.

DNA, Bacterial↗

Activity of human extravascular temocillin concentrations simulated in an in-vitro kinetic model against beta-lactamase producing gram-negative bacilli.

An in-vitro kinetic model was used to demonstrate the bactericidal activity of concentrations of temocillin achieved in extravascular body fluids following a 1 g intravenous dosage in man. Concentrations of temocillin attainable in peripheral lymph were bactericidal for ampicillin-resistant strains of Escherichia coli, Enterobacter cloacae and Klebsiella oxytoca. Likewise, concentrations of temocillin achieved in human blister fluid following a 12-hourly dosage regimen were bactericidal for cultures of Ent. cloacae and K. oxytoca which were resistant, respectively, to simulated blister fluid concentrations of cefotaxime and aztreonam. The bactericidal activity of extravascular concentrations of temocillin against these multiresistant, Gram-negative bacteria was a reflection of the beta-lactamase-stability and good pharmacokinetic properties of temocillin.

Anti-Bacterial Agents↗

Comparative activities of amoxycillin, amoxycillin/clavulanic acid and tetracycline against Chlamydia trachomatis in cell culture and in an experimental mouse pneumonitis.

The activity of amoxycillin, amoxycillin/clavulanic acid and two tetracycline antibiotics was investigated against three strains of Chlamydia trachomatis in vitro. McCoy cells were infected and single doses of antibiotic administered 24 h after infection. The percentage of infected cells was calculated at intervals up to 72 h after infection. Amoxycillin and clavulanic acid, alone and in combination, reduced the incidence of inclusion formation of all three strains. Particularly good activity was observed against the laboratory-adapted strain C. trachomatis Sa2f and a clinical isolate C. trachomatis LB1, where a progressive reduction in numbers of inclusions was observed with time. Minocycline and oxytetracycline were the most active agents tested. In an experimental animal model, mice were inoculated intranasally with C. trachomatis MoPn (ATCC VR123) which caused a fatal pneumonia within 16 days, and treated orally for four days commencing at 24 h after infection. At doses producing clinically achievable serum concentrations, amoxycillin (10 mg/kg), amoxycillin/clavulanic acid (10 + 5 mg/kg) and minocycline (5 mg/kg) all protected the mice over a 21-day period. The majority of the animals treated with clavulanic acid alone (20 mg/kg) survived the infection. Treatment with oxytetracycline was less effective, a dose of 160 mg/kg being required to protect 70% of the mice. The results indicate that amoxycillin and amoxycillin/clavulanic acid were more effective against C. trachomatis MoPn in vivo than might be predicted from in-vitro data, suggesting that amoxycillin/clavulanic acid may have potential for the treatment of polymicrobial infections involving C. trachomatis.

Amoxicillin↗

Effect of low concentrations of clavulanic acid on the in-vitro activity of amoxycillin against beta-lactamase-producing Branhamella catarrhalis and Haemophilus influenzae.

Concentrations of amoxycillin/clavulanic acid achievable in the respiratory tract following oral dosage were assessed for in-vitro activity against beta-lactamase-producing strains of Branhamella catarrhalis and Haemophilus influenzae. In agar-dilution studies, 8 mg amoxycillin/l was required to inhibit 45 strains of beta-lactamase-producing B. catarrhalis, whereas all the strains were inhibited by 0.5 mg amoxycillin/l in the presence of 0.01 mg clavulanic acid/l. Similarly, 0.1 mg amoxycillin plus 0.05 mg clavulanic acid/l were bactericidal against beta-lactamase-producing strain of B. catarrhalis and prevented regrowth within 24 h. In tests against 43 beta-lactamase-producing strains of H. influenzae, concentrations of up to 128 mg amoxycillin/l were required for inhibition, whereas 32 strains (75%) were fully sensitive to amoxycillin (MIC 0.5 mg/l) in the presence of 0.12 mg clavulanic acid/l. These concentrations of amoxycillin/clavulanic acid were also bactericidal for a beta-lactamase-producing strain of H. influenzae. The study therefore showed that amoxycillin/clavulanic acid, at concentrations similar to those likely to be achieved in the respiratory tract following oral dosage, was bactericidal in vitro for beta-lactamase-producing isolates of B.catarrhalis and H. influenzae.

Amoxicillin↗

Bactericidal effects of amoxycillin/clavulanic acid against Legionella pneumophila.

The antibacterial activities of amoxycillin, clavulanic acid and the combination of both agents against Legionella spp. were compared in serial-dilution tests, time-kill curve studies and in turbidimetric studies in a continuous recording biophotometer. Both beta-lactam compounds showed high levels of activity against L. pneumophila in serial dilution tests, clavulanic acid (MIC 0.1-0.25 mg/l) being two-fold more active than amoxycillin. The combination of amoxycillin and clavulanic acid was more effective than either of the constituents and was two to four times more active than erythromycin. Clavulanic acid was shown to reduce the extent of inactivation of amoxycillin by L. pneumophila and amoxycillin/clavulanic acid was rapidly bactericidal against the organism in tests in which amoxycillin was ineffective. Microscopical examination showed distinctive morphological effects produced by amoxycillin and by clavulanic acid and synergy between the compounds could be attributed to beta-lactamase inhibition, or by binding to different penicillin binding proteins, or both. These results warrant further studies in vitro and in vivo to elaborate the bactericidal effects demonstrated by amoxycillin and clavulanic acid against Legionella spp.

Amoxicillin↗

Bactericidal effects of amoxycillin/clavulanic acid against intracellular Legionella pneumophila in tissue culture studies.

The bactericidal effects of amoxycillin, clavulanic acid and amoxycillin plus clavulanic acid were determined against Legionella pneumophila growing intracellularly in MRC-5 human fetal lung fibroblast cells. The strain of L. pneumophila was shown to be growing within the cells by transmission electron microscopy and this was confirmed by the results of bactericidal tests in which gentamicin was shown to be ineffective in preventing growth of the organism in the tissue culture system. Amoxycillin failed to prevent infection of the cell monolayers and had no effect on the growth of intracellular L. pneumophila. Transmission electron microscopy showed the presence of large numbers of bacteria of normal morphology within the fibroblasts. In contrast, clavulanic acid and amoxycillin/clavulanic acid protected the cell sheets from the effects of infection with L. pneumophila and reduced the numbers of intracellular bacteria to the same extent as erythromycin. Also, bacteria of abnormal morphology were observed within fibroblast cells of the cultures treated with clavulanic acid and the combination. These data demonstrate the penetration of clavulanic acid, when used alone or in the presence of amoxycillin, into cells infected with L. pneumophila and the resulting bactericidal activity of the agents against intracellular bacteria.

Amoxicillin↗

The evolution of antibiotic production and public health problems.

Antibiotic evolution is closely paralleled by the evolution of bacterial resistance. Prior to wide usage of penicillin G, resistance to beta-lactam antibiotics as a consequence of beta-lactamase production had been recognized, and has been an increasing clinical problem ever since. Discovery of antibiotics other than beta-lactams, such as macrolides, tetracyclines and aminoglycosides, has also resulted in the eventual selection of bacteria resistant to these agents. Synthesis of novel beta-lactam derivatives from 6-APA, such as methicillin and isoxazolyl penicillins, resistant to staphylococcal beta-lactamase, overcame the clinical problem of penicillin-resistant S. aureus. Likewise, the isolation of cephamycins and monobactams, and further exploitation of the cephalosporin nucleus, led to the development of derivatives which display a high degree of stability to a wide range of gram-positive and gram-negative bacterial beta-lactamases, thus rendering organisms producing these enzymes susceptible to these agents. Analogous modification of the penicillin nucleus, to give 6 alpha-substituted penicillins, also resulted in derivatives with exceptional stability to beta-lactamases. An alternative approach to the problem of beta-lactamase was the isolation or synthesis of substances able to inhibit the activity of enzymes, thus protecting the unstable beta-lactams from inactivation by beta-lactamase. In this way the activity of beta-lactamase-labile agents was effectively restored against a wide range of beta-lactamase-producing bacterial pathogens. The wide diversity of new antibacterial agents, together with an increasing knowledge and understanding of mechanisms of resistance, indicates that further advances against resistant bacterial pathogens is ensured.

Anti-Bacterial Agents↗

Antibacterial activity of resolved temocillin epimers.

The antibacterial activity of pure resolved R and S epimers of temocillin was determined in a variety of in-vitro test systems, including those that allowed measurement of activity during the early period following exposure to the agents, thus minimising the effect of epimerization. In conventional agar- and broth-dilution susceptibility tests involving incubation at 37 degrees C for 18 h, little difference was evident between the activities of the individual epimers. In contrast, in other tests of antibacterial activity, such as time-kill and turbidimetric studies, the R epimer and temocillin (R/S mixture 1.8:1.0) were shown to be more rapidly bactericidal than the S epimer. Overall, the R epimer and temocillin (R/S) exhibited a similar degree of bactericidal activity in vitro.

Bacteria↗

BRL 20330, an oral prodrug of temocillin: bioavailability studies in man.

BRL 20330 is the o-methyl phenyl ester of temocillin which is well absorbed after oral administration and converted to temocillin in the body. BRL 20330 was administered to healthy subjects in a three-part cross-over study with single doses equivalent to 400, 600 and 800 mg of temocillin. Peak serum concentrations of temocillin were 9.8, 12.8 and 15.8 mg/l respectively and concentrations of 3.0-6.0 mg/l were measured at 12 h after dosing. High and prolonged concentrations of temocillin were measured in the urine. The mean urinary recovery was 22-25% and only 0.2% of unhydrolyzed BRL 20330 was detected in the urine. Little difference in the extent of absorption was noted when BRL 20330 was administered with food although the peak levels of temocillin were delayed and reduced slightly. Urinary concentrations of temocillin, even after 24 h, were bactericidal for a number of Gram-negative bacteria including multi-resistant strains. BRL 20330 was well tolerated and there was no evidence of gastro-intestinal adverse effects.

Administration, Oral↗

Antibacterial activity of ticarcillin in the presence of clavulanate potassium.

The antibacterial effects produced by ticarcillin disodium plus clavulanate potassium, a combination of the broad-spectrum penicillin ticarcillin, and the beta-lactamase inhibitor clavulanic acid as the potassium salt, have been measured in vitro and in experimental infection studies. The presence of clavulanic acid resulted in a significant enhancement of the activity of ticarcillin against a wide range of beta-lactamase-producing bacteria. These included ticarcillin-resistant strains of Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, P. vulgaris, Yersinia enterocolitica, and the anaerobe Bacteroides fragilis. In addition, beta-lactamase-producing isolates of Hemophilus influenzae, Branhamella catarrhalis, Neisseria gonorrhoeae, and Staphylococcus aureus were susceptible to ticarcillin and clavulanate. Clavulanic acid did not influence the activity of ticarcillin against ticarcillin-susceptible bacteria. The bactericidal effects of the antibiotic combination were measured in an in vitro kinetic model in which the drug concentrations were varied to simulate those measured in humans after intravenous dosing with ticarcillin (3.0 g) and clavulanate potassium (100 mg clavulanic acid). In these tests, ticarcillin plus clavulanic acid had pronounced bactericidal activity against ticarcillin-resistant bacteria. The protection of ticarcillin by clavulanic acid from inactivation by bacterial beta-lactamases in vivo was demonstrated in experimental infection models in which the efficacy of the ticarcillin plus clavulanic acid combination against infections caused by beta-lactamase-producing bacteria was correlated with the presence of effective concentrations of both antibiotic and inhibitor at the site of infection.

Animals↗

Human pharmacokinetics of temocillin (BRL 17421) side chain epimers.

The pharmacokinetics of the side-chain epimers of temocillin were investigated in four healthy male subjects following a single iv dose of temocillin disodium (1 g pure free acid) containing 64.2% R-epimer. Plasma and urinary concentrations of the epimers were determined by hplc methods. The R-epimer was twice as rapidly cleared, had a 23% larger volume of distribution and a 60% shorter beta half-life than the S-epimer. Intermediate values were obtained for total temocillin (from hplc data). The differences in the pharmacokinetic properties of the epimers are most likely the result of different extents of plasma protein binding. In each plasma sample, the free fraction of the R-epimer was higher (up to two-fold) than that of the S-epimer. In a comparison of temocillin pharmacokinetic parameters derived from hplc and microbiological assay data, the values obtained from the latter analyses reflected most closely those for the R-epimer. Further indications that the R-epimer is more microbiologically active against Pseudomonas aeruginosa NCTC 10701 from other assessments of relative antibacterial activity are discussed.

Adult↗