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Biomedical subjects

D S Reeves

Publications and source records attributed to D S Reeves.

At least 73 records · Page 4Linked to original sources
PubMed1994

A perspective on the safety of antibacterials used to treat urinary tract infections.

The safety of antibacterials used to treat urinary tract infections is reviewed. The types of side-effects found relate to the gastrointestinal tract, the female genital tract, and the skin, with miscellaneous complaints such as headache also occurring. Gastrointestinal effects are by far the most common and may be induced by direct irritation of the bowel, alteration of gut flora, direct stimulation of smooth muscle or alteration of bacterial metabolism of bile acid. Rare toxic effects specific to individual agents are also observed. There is no perfect treatment for urinary tract infections but from the point of view of safety, beta-lactams, nitrofurantoin and for fomycin, while causing a significant incidence of minor side-effects, are only very rarely associated with serious toxicity.

Anti-Infective Agents, Urinary↗
PubMed1994

An evaluation of three new immunoassays for determination of serum gentamicin concentrations.

Three new immunoassays for determination of serum gentamicin concentration were assessed: a latex agglutination assay (Technicon), an enzyme immunoassay (EMIT 2000) and a multi-layer thin-film immunoassay (Opus). All three were easy to use, had good within- and between-assay reproducibility, good reliability and acceptable linearity. The standard curve stability was shortest with the latex agglutination assay and longest with the thin-film. The thin-film assay calibrators gave approximately double the expected concentration when assayed by polarisation fluoroimmunoassay but this did not effect the assay's performance. When compared with the polarisation fluoroimmunoassay results of patient samples, all three methods gave an excellent correlation. The technical aspects of these three methods make them acceptable for clinical use.

Calibration↗
PubMed1994

Antibiotics at the extremes of age: choices and constraints.

Infection is a frequent cause of morbidity and mortality at the extremes of life. Its treatment is complicated by a lack of specificity in the clinical findings and wider range of pathogens than in other patients. For these reasons empirical therapy must cover a wide range of pathogens and yet, because the clinical findings may not even be due to infection, it should be as non-toxic as possible. It is also essential to investigate intensely before therapy so as to stand the best chance of making an aetiological diagnosis and possibly allowing a change to more directed therapy. Neonates in particular, but also the elderly, are susceptible to age-associated antibiotic toxicities, such as those from tetracyclines and chloramphenicol. Polypharmacy in the elderly renders them particularly liable to drug interactions. Both age groups have altered pharmacokinetics of antibiotics, including differences in absorption, distribution and elimination compared with healthy adults, and therapeutic drug monitoring may be needed more frequently as a result.

Aged↗
PubMed1993

The activity of cefpirome and ten other antibacterial agents against 2858 clinical isolates collected from 20 centres.

Two thousand eight hundred and fifty-eight aerobic clinical isolates of Enterobacteriaceae, Pseudomonas species, staphylococci, streptococci and Haemophilus species were collected in 19 geographically separated centres in the UK and one in Ireland. The identity of each isolate was confirmed at Southmead Hospital and the MIC of cefpirome, cefotaxime, ceftazidime, cefuroxime, cephradine, amoxycillin, piperacillin, imipenem, gentamicin, ciprofloxacin and trimethoprim was determined by an agar dilution method. Against species of Enterobacteriaceae not associated with producing an inducible cephalosporinase, cefpirome had a similar degree of activity to cefotaxime and was more active than ceftazidime and earlier cephalosporins. Against species with a high prevalence of inducible beta-lactamase production, cefpirome was superior to other cephalosporins; imipenem was also active against these isolates. Cefpirome was active against Pseudomonas aeruginosa, methicillin-sensitive staphylococci, non-enterococcal streptococci and Haemophilus spp. When the isolates were exposed to 0.1 mg/L of imipenem in agar plus the test agent, cefpirome had superior activity compared with the other cephalosporins tested for the Enterobacteriaceae, except Proteus vulgaris and Proteus penneri. 8.7% of Enterobacter spp., 7% of Citrobacter spp. and 6.7% of Morganella morganii had susceptibilities to beta-lactams suggesting constitutive hyperproduction of chromosomal cephalosporinase; cefpirome, unlike the other cephalosporins tested, was active against these isolates, although to a lesser degree than against the wild-type inducible isolates. No isolates were thought to produce an extended-spectrum beta-lactamase.

Anti-Bacterial Agents↗
PubMed1993

An eight-year survey of the antimicrobial susceptibility patterns of 85,971 bacteria isolated from patients in a district general hospital and the local community.

Antimicrobial susceptibilities were determined for 85,971 bacteria isolated from clinical specimens in the microbiology department of a single district general hospital during the eight-year period between 1984 and 1991. The isolates included 45,786 coliforms, 4483 Proteus spp. and 2644 Pseudomonas spp. from urine and 13,324 Staphylococcus aureus, 7311 beta-haemolytic streptococci, 4741 coliforms, 3643 Pseudomonas spp., 2778 Haemophilus influenzae, 638 Proteus spp. and 623 Streptococcus pneumoniae from other sites (excluding blood). Patterns of susceptibility remained largely unchanged during the study period, except for a decline in the susceptibility of Proteus spp. to trimethoprim between 1984 and 1988 which had reversed itself by 1990 and a reduction in the susceptibilities of Pseudomonas spp. and S. aureus to ciprofloxacin between 1986 and 1991. The susceptibilities of coliforms which had been isolated from sites other than the urinary tract to ampicillin, cefazolin and cefuroxime decreased between 1984 and 1988 but a more variable pattern was noted in subsequent years. Susceptibility of S. aureus to penicillin fell during the first five years of the study but has remained stable since. No change was observed in the susceptibility pattern of H. influenzae. In our experience, gentimicin-resistant Gram-negative bacilli, methicillin-resistant S. aureus and penicillin-resistant S. pneumoniae were rarely isolated.

Bacterial Infections↗