Search PubMed⌕ Search

Biomedical subjects

C D Ericsson

Publications and source records attributed to C D Ericsson.

103 records · Page 6Linked to original sources
PubMed1977

Bismuth subsalicylate inhibits activity of crude toxins of Escherichia coli and Vibrio cholerae.

The inhibition of the activity of enterotoxins by bismuth salts was assessed in laboratory models. In the Y-1 adrenal cell tissue culture system, a commercial preparation containing bismuth subsalicylate reduced the activity of crude toxin from Vibrio cholerae by 10(4)-fold as compared with the activity of controls. Similar results were obtained with use of the adult rabbit ligated intestinal loop model. The preparation failed to affect crude Escherichia coli or cholera toxin activity once these toxins had become bound to intestinal mucosa. Pretreatment of ligated loops with the preparation reduced the fluid accumulation mediated by crude E. coli and cholera toxins by 78% and 91%, respectively. Bismuth subsalicylate and the complex vehicle of the preparation also inactivated toxin; however, bismuth subsalicylate was more effective when combined with the vehicle. Bismuth subcarbonate failed to inhibit fluid accumulation in ligated loops. Preparations containing bismuth subsalicylate may be effective in the prevention of diarrhea mediated by toxigenic E. coli.

Animals↗
PubMed1977

Minocycline treatment failure in pneumonia caused by minocycline-sensitive Streptococcus pneumoniae.

A previously healthy 23-year-old white woman had fulminant pneumococcal pneumonia complicated by empyema and bilateral pneumothoraces. Despite early treatment with the recommended doses of minocycline, the disease progressed. The S pneumoniae isolate was resistant to a 30microgram tetracycline disk and showed an MIC of 3.13microgram/ml for minocycline and 12.5 microgram/ml for tetracycline; these levels are considered by the manufacturer to indicate sensitivity to minocycline and intermediate sensitivity to tetracycline. The tetracyclines, including minocycline, should not be used to treat bacterial pneumonia since resistant strains of pneumococci are not uncommon and inffective treatment can lead to rapid progression of the infection. This case suggests that the levels of minocycline considered to indicate sensitivity in vitro be reassessed.

Adult↗
PubMedDate not supplied

Antisecretory and antiinflammatory properties of bismuth subsalicylate.

The antisecretory properties of Pepto-Bismol (PB) and its active ingredient, bismuth subsalicylate (BSS), were studied in ligated (rabbit and pig) and unligated (rat) intestinal-segment models. When PB was administered to segments before intestinal inoculation with heat-labile (LT) Escherichia coli or Vibrio cholerae enterotoxins, the inhibition of fluid accumulation was 74%-94% and 60%-91%, respectively. In the pig, the percentages of inhibition by PB of fluid accumulation produced by organisms or toxins were 69% for E. coli P57 producing heat-stable enterotoxin (ST), 89%-95% for E. coli P155 producing ST and LT, 52% for ST alone, 95% for LT alone, and 73% for ST and LT. When PB was administered to the pig immediately after inoculation with E. coli P57, E. coli P155, ST alone, LT alone, or ST and LT, the percentages of inhibition of fluid accumulation were 76%, 80%, 56%, 97%, and 69%, respectively. However, in the rabbit and rat, PB failed to inhibit fluid accumulation when it was administered 5-60 minutes after inoculation of cholera or E. coli LT enterotoxins. In the rabbit the combination of BSS and the vehicle of PB was synergistic in preventing the fluid accumulation normally produced by cholera toxin. Finally, when PB or BSS was administered 30 minutes before intestinal inoculation with arachidonic acid in a rat model of inflammatory diarrhea, the percentages of inhibition of fluid accumulation ranged, in a dose-responsive fashion, from 16% to 113% for PB and from 25% to 111% for BSS.

Animals↗
PubMedDate not supplied

Use of bismuth subsalicylate for the prevention of travelers' diarrhea.

During the months of July 1977 and July 1985, students from the United States participated in a double-blind, placebo-controlled trial examining the effectiveness of liquid bismuth subsalicylate (BSS) (1977) and two dosages of the tablet formulation of BSS (1985) in preventing diarrhea while in Guadalajara, Mexico. In the first study, 62 subjects received BSS for 3 weeks at a dosage of 60 mL four times daily (4.2 g of BSS/d) compared with 66 students receiving an oral placebo at a similar dosage schedule. In the second study, 51 students took two tablets four times daily (2.1 g of BSS/d), 63 took one tablet four times daily (1.05 g of BSS/d), and 58 took a placebo (two tablets taken four times daily), each for 3 weeks. In the initial study, 14 (23%) BSS-treated subjects developed diarrhea compared with 40 (61%) placebo-tested persons (P less than .0001). In the second trial, seven (14%) subjects taking two tablets of BSS four times daily, 15 (24%) taking one tablet of BSS four times daily, and 23 (40%) receiving placebo tablets experienced diarrhea (P less than .001 for the higher dose). The percent protection provided by BSS was 62% for the group that received 4.2 g/d, 65% for 2.1 g/d, and 40% for 1.05 g/d, when compared with the corresponding placebo group. In cases in which stools were analyzed, seven (24%) of 29 BSS-treated subjects who had diarrhea had a detectable enteric pathogen, compared with 35 (59%) of 59 of those randomized to receive a placebo. BSS was well tolerated.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Antimicrobial agents in the prevention of travelers' diarrhea.

Each of 433 adults traveling to Guadalajara, Mexico, from the United States during summer months was enrolled in one of four clinical trials of the protective effect of antimicrobial agents against travelers' diarrhea. Only one (2%) of 57 subjects taking trimethoprim-sulfamethoxazole (160 mg/800 mg daily) experienced diarrhea during a two-week study, whereas eight (14%) of 58 subjects taking trimethoprim alone (200 mg daily) and 10 (33%) of 30 taking placebo developed illness (P less than .05 and P less than .0001, respectively). Diarrhea occurred significantly less frequently among subjects receiving trimethoprim than among placebo recipients (P less than .05). None of 11 students given bicozamycin (500 mg four times daily) developed diarrhea during a three-week study, whereas 10 (53%) of 19 placebo recipients became ill (P = .003). Four (7%) of 54 subjects receiving norfloxacin (400 mg daily) experienced diarrhea during a two-week study; in contrast, 34 (60%) of 57 placebo recipients developed diarrhea (P less than .0001). The various antimicrobial agents prevented illness due to enterotoxigenic Escherichia coli and Shigella as well as that unassociated with a pathogen. The drugs were well tolerated. Current evidence suggests that trimethoprim-sulfamethoxazole is the optimal antimicrobial agent available for prophylaxis of travelers' diarrhea.

Adult↗
PubMedDate not supplied

Nonantibiotic therapy for travelers' diarrhea.

Several trials have shown that nonantibiotic drugs are efficacious in the treatment of travelers' diarrhea. When compared with placebo (P less than .025), bismuth subsalicylate (Pepto-Bismol) taken orally at a dosage of as low as 30 ml every half hour for eight doses was shown to be effective in reducing the frequently of episodes of diarrhea. Preliminary results indicated that loperamide (two 2-mg capsules followed by one capsule after each loose bowel movement) was more effective (P less than .025) than bismuth subsalicylate in relieving diarrhea. Likewise, preliminary results showed that BW942c, an unlicensed endorphin-like pentapeptide, offered more relief of diarrhea in the first 12 hr of therapy than did trimethoprim-sulfamethoxazole (P = .02) or placebo (P = .0007). Use of a nonantibiotic drug for empiric treatment of travelers' diarrhea appears to be a reasonable approach, especially for patients with mild to moderate disease and with no evidence of high fever or dysentery.

Antidiarrheals↗
PubMedDate not supplied

Antimicrobial therapy for travelers' diarrhea.

Three clinical trials were carried out to examine the efficacy of various antimicrobial agents in the treatment of travelers' diarrhea among students from the United States in Mexico. Thirty-seven subjects received twice daily for five days 160 mg of trimethoprim (TMP) and 800 mg of sulfamethoxazole (SMZ), 38 received 200 mg of TMP, and 35 received a placebo. Another group of students were given 100 mg of furazolidone (47 students) or ampicillin (47 students) four times a day for five days. In the third study, 500 mg of bicozamycin (72 students) or a placebo (68 students) was given four times a day for three days. Most students who received TMP-SMZ (78%), TMP (84%), or bicozamycin (85%) had recovered by 48 hr after initiation of treatment, as compared with 14% and 47% in the corresponding placebo groups and 55% in the furazolidone group. The agents had a positive effect for all etiologic categories, including diarrhea due to enterotoxigenic Escherichia coli and Shigella strains and illness without any established etiologic agents. Treatment failures were unusual with TMP-SMZ, TMP, and bicozamycin therapy (5% vs. 39% for the placebo-treated students). The drugs were well tolerated. The use of TMP-SMZ or TMP alone in the empiric treatment of moderate to severe travelers' diarrhea is advocated.

Adult↗
PubMedDate not supplied

Rifaximin: a nonabsorbed antimicrobial in the therapy of travelers' diarrhea.

BACKGROUND/AIMS: Bacterial enteropathogens, the major cause of travelers' diarrhea, are customarily treated with antibacterial drugs. Rifaximin, a nonabsorbed antimicrobial was examined as treatment for travelers' diarrhea. METHODS: A randomized, prospective, double-blind clinical trial was carried out in 72 US adults in Mexico. Patients with acute diarrhea received one of three doses of rifaximin (200, 400 and 600 mg t.i.d.) or trimethoprim/sulfamethoxazole (TMP/SMX, 160 mg/800 mg b.i.d.) for 5 days. Results were compared with data from 2 placebo-treated historical control populations. RESULTS: The shortest duration of treated diarrhea was seen in the group receiving 200 mg rifaximin t. i.d (NS). Clinical failure to respond to treatment occurred in 6 of 55 (11%) rifaximin-treated subjects versus 5 of 17 (29%) of TMP/SMX-treated subjects (NS). Sixteen of twenty (80%) of the enteropathogens isolated from the rifaximin-treated subjects and 7 of 7 (100%) from the TMP/SMX group were eradicated by treatment (NS). Sixteen of twenty-four (67%) enteropathogens identified were susceptible to TMP and all 24 were inhibited by</=50 microgram/ml of rifaximin. Rifaximin reduced the number of unformed stools passed during the first 24 h of treatment when compared with 2 control placebo groups (3.3 versus 5.1; p = 0.008 and 0.0001) and led to a reduced duration of post-enrollment diarrhea (mean values of 43.1 versus 68.1 and 81.9 h; p = 0.001). CONCLUSIONS: Rifaximin shortened the duration of travelers' diarrhea compared with TMP/SMX and 2 earlier studied placebo-treated groups. A poorly absorbed drug if effective in treating bacterial diarrhea has pharmacologic and safety advantages over the existing drugs.

Acute Disease↗