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D Felmingham

Publications and source records attributed to D Felmingham.

96 records · Page 6Linked to original sources

Comparative in vitro activity of lomefloxacin, a difluoro-quinolone.

Lomefloxacin is a new difluoro-quinolone. In this study, we have determined the in vitro activity of lomefloxacin against a wide range of clinical bacterial isolates and compared it with that of other fluoro-quinolones and some unrelated antimicrobials. Lomefloxacin was very active against Enterobacteriaceae (MIC90, 0.5 micrograms/ml) with activity comparable to that of ofloxacin (MIC90, 0.25 micrograms/ml). Lomefloxacin was moderately active against isolates of Pseudomonas aeruginosa (MIC90, 4 micrograms/ml), and again the activity was comparable to ofloxacin (MIC90, 4 micrograms/ml) but was eightfold less than ciprofloxacin (MIC90, 0.5 micrograms/ml). Lomefloxacin was also active against isolates of Staphylococcus aureus (MIC90, 1 micrograms/ml), irrespective of methicillin susceptibility, and this activity was most comparable to ofloxacin (MIC90, 0.5 micrograms/ml) and ciprofloxacin (MIC90, 0.5 micrograms/ml). Lomefloxacin was fourfold less active than either ofloxacin or ciprofloxacin against isolates of Enterococcus faecalis (MIC90, 8 micrograms/ml) and Streptococcus pneumoniae (MIC90, 8 micrograms/ml). In common with ofloxacin and ciprofloxacin, lomefloxacin was very active against isolates of Neisseria spp. (MIC90, less than or equal to 0.06 micrograms/ml), Haemophilus spp. (MIC90, less than or equal to 0.06 micrograms/ml), Legionella spp. (MIC90, less than or equal to 0.06 micrograms/ml), Vibrio spp. (MIC90, less than or equal to 0.06 micrograms/ml), and Campylobacter jejuni (MIC90, 1 microgram/ml). Lomefloxacin showed poor activity against isolates of Bacteroides spp. (MIC90, 16 micrograms/ml) or Clostridium difficile MIC90, 32 micrograms/ml) and was only moderately active against isolates of Clostridium perfringens (MIC90, 2 micrograms/ml), Peptostreptococcus spp. (MIC90, 4 micrograms/ml), Chlamydia trachomatis (MIC90, 4 micrograms/ml), Mycoplasma hominis (MIC90, 2 micrograms/ml), and Urea-plasma urealyticum (MIC90, 8 micrograms/ml). Lomefloxacin was found to be bactericidal at concentrations generally close to the MIC with greater than 3 log10 reduction in viability of exponentially dividing cultures of Escherichia coli and S. aureus within 5 hr of exposure to concentrations at eight times the MIC. These results indicate a potential clinical role for lomefloxacin in the treatment of genitourinary tract infections caused by Gram-positive and Gram-negative bacteria, respiratory tract infections caused by susceptible organisms, and soft tissue infections caused by S. aureus.

4-Quinolones↗

In vitro activity of lomefloxacin and other antimicrobials against bacterial enteritis pathogens.

Lomefloxacin is a new, difluoroquinolone. In this study, the in vitro activity of lomefloxacin against clinical isolates of a variety of bacterial species associated with acute diarrheal disease was determined and compared with that of ciprofloxacin, ofloxacin, amoxicillin, sulphamethoxazole, trimethoprim, tetracycline, and chloramphenicol. Bacterial isolates were obtained from different geographical areas, including Western Europe and the United Kingdom, Southern Europe, Africa, the Middle East, South and Southeast Asia, and South America, and were included to reflect the range of susceptibility seen throughout the world. Minimum inhibitory concentrations (MICs) were determined using an agar incorporation technique in Mueller-Hinton medium supplemented when necessary with saponin-lysed horse blood at a final concentration of 10% vol/vol. Lomefloxacin was highly active against all the species examined which included Salmonella spp., Shigella spp., Escherichia coli enterotoxigenic [(ETEC), enteroinvasive (EIEC), and enteropathogenic (EPEC) strains], Yersinia enterocolitica, Campylobacter jejuni, Vibrio spp., and Aeromonas hydrophila, with all isolates inhibited by 1 mg/L or less. This activity was similar to ofloxacin and slightly less than that of ciprofloxacin. By contrast, many of the isolates were resistant to one or more of the other, unrelated animicrobials. No cross-resistance between lomefloxacin and any of the nonfluoroquinolone antimicrobials examined in the study was observed.

Anti-Bacterial Agents↗

Treatment of gonococcal urethritis in men with a rifampicin-erythromycin combination.

A group of men with uncomplicated gonococcal urethritis were treated with a single oral dose of rifampicin (900 mg) and erythromycin stearate (1 g). Neisseria gonorrhoeae was isolated from four of 108 men at the first follow-up examination, and from none of 68 who attended a second follow-up examination. It is concluded that this rifampicin-erythromycin combination may be useful for the therapy of gonorrhea. It may be of particular value in the treatment of infections due to penicillin-resistant N. gonorrhoeae, since in vitro studies showed that both rifampicin and erythromycin were active against 20 strains of beta-lactamase-producing N. gonorrhoeae. The effect of this rifampicin-erythromycin combination against associated infections with Chlamydia trachomatis was disappointing. This organism was isolated from five of nine patients who had yielded isolates of C. trachomatis before treatment.

Administration, Oral↗

Treatment of Neisseria gonorrhoeae infections in men with single-dose thiamphenicol.

A group of 50 men with uncomplicated gonococcal infections were treated with single, oral doses of 2.5 g of thiamphenicol. Reexamination, which included culture for Neisseria gonorrhoeae, was performed three to four days and seven days after treatment. Thirty-two (91%) of 35 men with urethral infections, 13 (87%) of 15 with rectal infections, and four (57%) of seven with pharyngeal infections were cured. None of the men from whom N. gonorrhoeae was reisolated admitted further sexual exposure. Treatment failure did not correlate with decreased sensitivity of the isolates to thiamphenicol in vitro. Three men had urethral infections with Chlamydia trachomatis before therapy, and the organism was reisolated after therapy in every case. No hematologic abnormalities occurred in any of the 50 patients treated with thiamphenicol, but 13 (26%) developed adverse gastrointestinal symptoms.

Administration, Oral↗

Activity of thiamphenicol against Chlamydia trachomatis and Neisseria gonorrhoeae.

The in-vitro activity of thiamphenicol against Neisseria gonorrhoeae was compared with that of penicillin. A total of 267 isolates were tested. All strains were inhibited by less than or equal to 4.0 micrograms of thiamphenicol/ml. However, the minimal inhibitory concentration of thiamphenicol was fourfold higher (MIC90 = 2.0 micrograms/ml) for beta-lactamase-producing strains or those moderately resistant to penicillin than for penicillin-sensitive strains (MIC90 = 0.5 micrograms/ml). The MIC of thiamphenicol for Chlamydia trachomatis was determined for a control strain and for 15 recent clinical isolates. The MIC90 for thiamphenicol was 1.0 micrograms/ml, as compared with a MIC90 of oxytetracycline of 0.12 micrograms/ml against the same isolates.

Chlamydia trachomatis↗