Biomedical subjects
Publications and source records attributed to D S Reeves.
Two patients with urinary candidiasis were treated with 5-fluorocytosine. Serum levels of the drug and a study of its excretion in urine are recorded together with a brief account of its activity in body fluids. Evidence of toxicity was not observed with dosages of from 2 to 5 g a day.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Trimethoprim is inhibitory for a wide range of bacteria, and when used in combination with a sulphonamide marked synergy has been reported.In order to test its value in the treatment of urinary infections 154 hospital patients with infections of varying severity and due to a wide range of organisms were treated with combinations of sulphamethoxazole and trimethoprim. Combinations of these substances in two different ratios (2:1 and 10:1) were used in 113 patients, and one week after the end of treatment about three-quarters were cured by both combinations. In a second study 106 patients were treated with a sulphamethoxazole-trimethoprim combination (5:1), ampicillin, or sulphadimidine. The cure rate with the 5:1 combination was higher than that found with ampicillin or sulphadimidine both one week after finishing treatment (sulphamethoxazole-trimethoprim 85%, ampicillin 70%, sulphadimidine 40%) and at the fourth- to fifth-week follow-up (sulphamethoxazole-trimethoprim 67%, ampicillin 52%, sulphadimidine 15%).The results obtained with the various sulphamethoxazole-trimethoprim combinations did not indicate that a particular ratio was superior for treating urinary infections in general or for those caused by any particular species of organism.Laboratory studies showed that many bacteria causing urinary infections in hospital were sensitive to trimethoprim, and the therapeutic results could have been largely predicted from a knowledge of the in-vitro sensitivity tests to trimethoprim alone. For example, sulphamethoxazole-trimethoprim in the treatment of Proteus mirabilis infections was less successful than in those due to Escherichia coli, and this finding was clearly reflected in the higher minimal inhibitory concentrations for trimethoprim of Pr. mirabilis.The sulphamethoxazole-trimethoprim combination was simple to administer, free from side-effects, and gave satisfactory results in the treatment of urinary infections that occurred in hospital patients.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The quinolone antibacterials are proving very useful in the management of infection, notably for the treatment of Gram-negative bacteria. With the increasing use of these drugs, adverse effects are being recognised more often and careful documentation is still required. In general, the quinolones are of low toxicity. Gastrointestinal adverse effects are the most common, and are usually mild; indeed, all adverse events are generally mild and resolve on withdrawal of the offending drug. Certain precautions and contraindications are apparent. Because drug-induced arthropathies occur in juvenile animals, quinolones should not be administered to pregnant or lactating women or to growing children, unless the clinical benefit outweighs the risk. Caution should also be observed in patients with previous epilepsy or severe cerebral arteriosclerosis. Neurological effects may require the use of appropriate neuro- and psychoactive drugs, as well as the withdrawal of the precipitating agent. Hypersensitivity reactions to a fluoroquinolone may require the use of antihistamines, and in some cases topical or systemic steroids, and may well preclude future use of a fluoroquinolone. Dose adjustments may be necessary in patients with reduced renal function, when the measurement of serum concentrations may be desirable. Interstitial nephritis, haematuria and acute renal failure are rare effects of quinolone therapy which will require appropriate management including withdrawal of the precipitating drug. Interactions with theophylline and warfarin are of clinical significance, and may require plasma concentration monitoring and adjustment of dosage.