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Biomedical subjects

D C Shanson

Publications and source records attributed to D C Shanson.

At least 91 records · Page 5Linked to original sources
PubMed1984

Erythromycin compared with a combination of ampicillin plus flucloxacillin for the treatment of community acquired pneumonia in adults.

Erythromycin was compared with a combination of ampicillin plus flucloxacillin for treating adults admitted to hospital with community acquired pneumonia. A satisfactory clinical response to a seven day course of antibiotics was observed in 29 of 36 patients (81%) in the erythromycin group and 35 of 39 patients (90%) treated with ampicillin plus flucloxacillin, as judged by a fall in temperature, improvement in the general condition, diminution of respiratory symptoms and radiographic improvement. Streptococcus pneumoniae was the causative organism most commonly detected and a satisfactory outcome of treatment of diagnosed pneumococcal pneumonia cases was observed in 16 of 18 patients (89%) treated with erythromycin compared with 20 of 22 patients (91%) treated with ampicillin plus flucloxacillin. These results indicate that erythromycin has similar clinical efficacy to ampicillin plus flucloxacillin, given as a seven day course, for the treatment of community acquired pneumonia in adults.

Adult↗
PubMed1984

The pharmacokinetics and tolerance of oral erythromycin stearate compared with erythromycin ethylsuccinate: implications for preventing endocarditis.

Serum concentrations of erythromycin were monitored in 11 healthy adult volunteers following single dose oral administration of erythromycin stearate, 1.5 g, and erythromycin ethylsuccinate 3.0 g. Peak serum concentrations occurred at 30 min to 2 h after the dose, usually at 1 h. Mean serum peak erythromycin concentrations (standard deviation) were 4.8 mg/l (+/- 2.0) following 1.5 g erythromycin stearate and 2.8 mg/l (+/- 1.4) after 3.0 g erythromycin ethylsuccinate. Both types of erythromycin frequently caused mild gastrointestinal side-effects but there were fewer side-effects associated with erythromycin ethylsuccinate. However, because of the increased serum erythromycin concentrations between 1 and 6 h after the dose of the stearate preparation compared to ethylsuccinate we recommend erythromycin stearate, 1.5 g, as the preferred loading dose, given 1 h before the dental procedure, for preventing endocarditis in susceptible patients allergic to penicillin.

Administration, Oral↗
PubMed1984

Effect of volume of blood cultured on detection of Streptococcus viridans bacteraemia.

Fifty eight patients undergoing dental extraction each had 45 ml blood collected. This was divided into 30 ml and 15 ml blood samples for culture. The 30 ml sample was inoculated into 120 ml nutrient broth with 0.05% liquoid and the 15 ml sample into 60 ml of identical broth so that the final dilution of blood in broth was always 1/5. Bacteraemia due to viridans streptococci was found in 27 and 15 patients by culturing the 30 ml and 15 ml blood samples respectively. Only one further case of streptococcal bacteraemia was detected by culture of the total volume of blood collected (45 ml) rather than culture of the 30 ml blood sample alone. These findings suggest that the culture of 30 ml blood results in the detection of up to 80% more blood cultures yielding Streptococcus viridans than the culture of only 15 ml blood. The collection of more than 30 ml blood for each culture is unlikely to prove worthwhile. It is suggested that 30 ml rather than 15 ml blood is probably the optimal volume of blood for each culture of S viridans when patients with suspected infective endocarditis are investigated.

Adult↗
PubMed1984

Adult community-acquired pneumonia in central London.

Strep. pneumoniae was diagnosed as the cause of pneumonia in 40 (50%) of 80 consecutive adults admitted to St Stephen's Hospital with community-acquired pneumonia. None of the patients had evidence of Mycoplasma pneumoniae infection, and Legionella pneumophila serology was positive on only one occasion. In 29 patients (36%) no causative organism was demonstrated. The diagnosis of pneumococcal infection was obtained in 15 cases by isolating Strep. pneumoniae from the sputum, in 13 further cases by demonstrating pneumococcal capsular antigen in sputum, and in 12 other cases by detecting pneumococcal antigen in serum only. Only 2 cases with pneumococcal pneumonia were bacteraemic and 3 patients (7%), all aged more than 75 years, died. The relatively low bacteraemic and mortality rates suggest that community-acquired pneumococcal pneumonia currently seen in patients admitted to hospital in central London may not be so severe as in some other areas.

Adult↗
PubMed1983

Streptobacillus moniliformis isolated from blood in four cases of Haverhill fever.

During February, 1983, an outbreak of an unusual febrile illness occurred in over 130 children attending a boarding school in Chelmsford, Essex. The clinical features included fever, an erythematous rash that was most prominent on the hands and feet, arthralgia, and the subsequent development of a sore throat. The nature and distribution of the rash varied considerably between patients and at different stages of illness. At first a viral aetiology was regarded as most likely. When Streptobacillus moniliformis was later isolated from the blood of 4 of the patients with moderately severe illnesses it became apparent that an outbreak of Haverhill fever had occurred at this school. The most probable source of the outbreak was raw milk, since all 4 patients had consumed raw milk at the school shortly before the onset of symptoms and there was no evidence of person-to-person spread of infection.

Adolescent↗
PubMed1983

Clinical comparison of glucose broth with nutrient broth blood cultures for the detection of "Streptococcus viridans" bacteraemia.

Viridans streptococci were isolated from the blood stream of half of 50 patients undergoing dental extractions approx. 2 min before blood culture. Glucose and nutrient broths were tested in parallel. There was no significant difference between the isolation rates of streptococci by the two methods after incubation for 7 days, nor did the addition of glucose 0.1% to nutrient broth significantly increase the speed of detection of streptococci; the isolation rates of streptococci during the first 48 h of incubation were similar with both types of broth. Although there were a few more isolations of streptococci from the glucose broth than from the nutrient broth during the first 20 h, the difference was not statistically significant. No rapid lethal effect against streptococci was observed in glucose broth during incubation for 7 days. These results suggest that adding glucose 0.1% to nutrient broth for blood culture does not influence the recovery of organisms from patients with "Streptococcus viridans" bacteraemia after incubation of the broth for 2-7 days.

Culture Media↗
PubMed1983

Effect of adding a papain digest of ox liver to brain heart infusion cysteine broth on the recovery of non-sporing anaerobes from simulated blood cultures.

Panmede, a papain digest of ox liver, added to brain heart infusion cysteine broth improved the recovery of non-sporing anaerobes from simulated blood cultures where human blood was added to each broth. The brain heart infusion broth containing both cysteine and Panmede supported the best isolation of non-sporing anaerobes during the first 48 h incubation compared with the four commercial media tested in parallel. Good recovery of anaerobes during the first 24 h was obtained with the brain heart infusion broth supplemented with cysteine and Panmede, fastidious anaerobe broth and Brewer's thioglycollate from Southern Group Laboratories but not from Thiol medium and the other type of Brewer's thioglycollate medium tested.

Anaerobiosis↗
PubMed1981

Effect of adding cysteine to brain-heart infusion broth on the isolation of Bacteroides fragilis from experimental blood cultures.

Adding 0.05% cysteine to brain-heart infusion broth greatly improved the recovery of three strains of Bacteroides fragilis from simulated blood cultures. No bacteroides were isolated after 24 hours' incubation in brain-heart infusion broth without added cysteine, and this was therefore a poor medium for the isolation of B. fragilis. Results with brain-heart infusion broth containing 0.05% cysteine were similar to those obtained with commercially prepared Thiol and Brewer's thioglycollate media.

Animals↗