Sensitivity of gram-negative organisms to cefotaxime.
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Anti-Bacterial Agents↗
Biomedical subjects
C A Perlino
Publications and source records attributed to C A Perlino.
Metronidazole vs clindamycin treatment of anerobic pulmonary infection. Failure of metronidazole therapy.
Metronidazole has important in vitro bactericidal activity against strict anaerobic bacteria and has been used successfully in the treatment of infection due to these organisms. In this randomized study, the efficacy of metronidazole was compared with clindamycin in the treatment of patients with anaerobic lung abscess or necrotizing pneumonia. Six patients with lung abscesses and one with necrotizing pneumonia received metronidazole; six patients with lung abscesses, three with necrotizing pneumonia, and one with pneumonia and empyema received clindamycin. Three patients with lung abscesses and one with necrotizing pneumonia failed to respond to metronidazole treatment. One clindamycin-treated patient died of causes unrelated to antibiotic therapy. The results of this study suggest that metronidazole treatment of anaerobic pulmonary infections is less effective than currently available therapy.
Adult↗
Flavobacterium meningosepticum sepsis: disease due to bacteria with unusual antibiotic susceptibility.
The three cases we have presented implicate F meningosepticum as a significant pathogen causing disease in immunocompromised adult patients. Since this organism is of low pathogenicity but may be found in the hospital environment, its identification as a pathogen raises the suspicion of a nosocomial source of infection, and a search for the source should be made. Furthermore, with regard to the choice of antimicrobial therapy, it must be remembered that this organism is resistant to most antibiotics commonly used to treat gram-negative bacilli, and disk diffusion technics may not reliably predict actual antibiotic sensitivity.
Anti-Bacterial Agents↗
Legionnaires' disease outbreak at an Atlanta, Georgia, Country Club: evidence for spread from an evaporative condenser.
During July 1978 an outbreak of Legionnaires' disease characterized by high fever, prostration, and pneumonia occurred at an Atlanta, Georgia, country club. All eight cases involved club members whose primary club activity was golfing. The degree of golfing activity during the likely exposure period was a risk factor for acquiring the illness. Legionella pneumophila was isolated from the evaporative condenser within the clubhouse. The fact that the stream of air blowing from the exhaust duct of the evaporative condenser was directed toward a nearby practice green and the 10th and 16th tees supports the hypothesis that this outbreak represents airborne dissemination of L. pneumophila from the evaporative condenser to an outdoor site where susceptible golfers contracted the illness.
Aged↗
Severe local reactions to pneumococcal vaccine.
Two patients who received pneumococcal vaccine had severe pain and swelling that extended beyond the site of injection. Both patients were atopic, and each had either received pneumococcal vaccine in the past or had had extensive laboratory contact with pneumococci. Care must be exercised in selecting patients for revaccination with pneumococcal vaccines.
Adult↗
"Diphtheroid" pneumonia.
We have described a case of pneumonia caused by Corynebacterium CDC Group D2 which was diagnosed by Gram stain of a specimen obtained by transtracheal aspiration and recovery of the organisms from the aspirate specimen in pure culture. Treatment with penicillin was successful.
Aged↗
Penicillin-insensitive pneumococci: isolation from patients with pneumonia.
Pneumococci relatively insensitive to penicillin G were isolated from the sputum of two patients with pneumonia. One of the organisms was also relatively insensitive to ampicillin, cefamandole, and cephalothin and was resistant to tetracycline. Because penicillin-insensitive pneumococci are being reported with greater frequency, continued surveillance of pneumococcal sensitivity to penicillin is appropriate.
Adult↗
Cefamandole vs. procaine penicillin for treatment of pneumonia due to Streptococcus pneumoniae: a random trial.
The efficacy and safety of cefamandole nafate and penicillin G procaine suspension were compared in the treatment of pneumococcal pneumonia in hospitalized adults. One hundred thirteen patients with clinical and radiographic evidence of pneumococcal pneumonia were randomly assigned to receive 600,000 units of procaine penicillin intramuscularly every 12 hr or 500 mg of cefamandole intramuscularly every 6 hr. The two groups were comparable with regard to patient type and extent and severity of pneumonia. Alcohol abuse was a host factor in 31% of all patients in the trial. All strains of Streptococcus pneumoniae isolated were inhibited by less than or equal to 1.6 microgram of cefamandole/ml. Of 58 patients treated with cefamandole, 50 had a satisfactory response, as did 46 of the 55 patients treated with penicillin. Results of tests of liver function were abnormal (primarily, elevated levels of transaminase or alkaline phosphatase) in 38% of the entire group of patients and occurred with equal frequency in patients receiving cefamandole or penicillin. Side effects during therapy, including superinfection, occurred equally with either drug. In a random trial, cefamandole was as effective and safe as penicillin in the treatment of pneumococcal pneumonia in adults.
Adult↗
Detection of pneumococcal polysaccharide in the sputum of patients with pneumococcal pneumonia by counterimmunoelectrophoresis.
Each of 41 patients with bacterial pneumonia was placed into 1 of 4 categories based on the relative clinical certainty of the diagnosis of pneumococcal pneumonia. The frequency of pneumococcal polysaccharide in the sputum by counterimmunoelectrophoresis (CIE) was then noted for each diagnostic category of patients. Detection of pneumococcal polysaccharide in sputum correlated with the diagnostic certainty of pneumococcal pneumonia, while results of culture of sputum were less indicative of pneumococcal infection. Saliva of 83 normal individuals failed to give positive tests for pneumococcal polysaccharide despite the presence of alpha-hemolytic streptococci on culture. Furthermore, the mere presence of pneumococci in cultures did not predict a positive test for polysaccharide by CIE nor did the absence of pneumococci mean that polysaccharide would not be detected. This study suggests that detection of pneumococcal polysaccharide appears more rapid, more sensitive, and more specific than sputum cultures in diagnosing pneumococcal infection of the lung.
Counterimmunoelectrophoresis↗
Direct hemadsorption by cell cultures infected with rubella virus.
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Animals↗
Moxalactam therapy for bacterial pneumonia.
Therapy with moxalactam was evaluated in 71 patients with bacterial pneumonia. Ninety-two percent of patients with pneumonia due to gram-positive cocci, anaerobes, or Haemophilus influenzae were cured. One patient developed probable pneumococcal meningitis during treatment of sputum culture-positive pneumococcal pneumonia. Six of 10 patients with pneumonia due to Pseudomonas aeruginosa or Enterobacteriaceae were cured also. However, two of these patients became colonized with moxalactam-resistant organisms, which were of the same species as the organism that caused the original infection. Two of the four patients in whom treatment failed were infected with P. aeruginosa and then developed superinfection with moxalactam-resistant Pseudomonas. Phlebitis and pain on intramuscular injection were the most common adverse effects observed. The results of this study, demonstrate that moxalactam may constitute effective therapy for bacterial pneumonia, but the development of resistance during therapy may limit its usefulness against Pseudomonas infections.
Adolescent↗