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Biomedical subjects

F D Pien

Publications and source records attributed to F D Pien.

At least 55 records · Page 3Linked to original sources
PubMed1981

Antimicrobial spectrum, pharmacology, adverse effects, and therapeutic use of amikacin sulfate.

The antibiotic spectrum, pharmacology, adverse effects, and therapeutic use of amikacin sulfate are reviewed. Amikacin, a semisynthetic analog of kanamycin, is highly active against most gram-negative bacteria including many gentamicin-resistant strains. Amikacin's pharmacologic properties have been studied extensively in both children and adults. It achieves high, predictable, and prolonged blood concentrations with a favorable therapeutic index. Amikacin does cause nephrotoxicity and ototoxicity; however there is no conclusive evidence that these toxicities differ from those caused by other major aminoglycosides. The effectiveness of amikacin sulfate in the treatment of serious gram-negative bacillary infections is well documented. Amikacin sulfate is an important addition to the antibiotic armamentarium of a hospital with high gentamicin or tobramycin resistance. In hospitals without substantial aminoglycoside resistance, its use is debatable because amikacin has not been shown to have increased clinical efficacy compared with the other aminoglycosides for infections caused by susceptible bacteria.

Amikacin↗
PubMed1980

Rhodotorula septicemia: two cases and a review of the literature.

Rhodotorula glutinis var. glutinis was isolated from the blood of two patients who were seriously ill and required long-term intravenous therapy. Although both isolates were sensitive to amphotericin B and 5-fluorocytosine, neither patient received antifungal therapy. One of the two patients died, but Rhodotorula was not recovered at autopsy. Review of the literature shows that Rhodotorula septicemia is often associated with contamination of intravenous infusion equipment, resulting in toxemia and hypotension. Initial therapy for fungemia should consist of removal of infected cannulas and fluid replacement. If fungemia persists, antifungal drug therapy should be considered.

Adult↗
PubMed1979

Value of cultures in patients with acute cellulitis.

A retrospective review of blood and wound cultures obtained from adult patients admitted for acute cellulitis revealed positive culture rates of 0.77% of 86% respectively. Organisms from wound cultures were predominantly Staphylococcus aureus and Streptococcus pyogenes. The majority of our patients were otherwise healthy. Our study suggests that blood cultures are not necessary in acute cellulitis in adults without serious underlying diseases.

Adolescent↗
PubMed1979

Comparative study of prophylactic antibiotics in cardiac surgery. Clindamycin versus cephalothin.

A randomized, prospective study of the relative effectiveness of clindamycin versus cephalothin was performed in 263 adult patients having cardiac surgery from September, 1977, to August, 1978. There were no statistically significant differences in frequency of postoperative infections in these two antibiotic groups. Wound infection developed in 6.5 percent of the cephalothin group and 3.2 percent of the clindamycin group. Urinary tract infection developed in 5.6 percent of the clindamycin group and 2.1 percent of the cephalothin group. Four bacteremic episodes occurred in the clindamycin-treated patients, and one episode of bacteremia occurred in a cephalothin-treated patient. No cases of endocarditis occurred during the study. Clindamycin deserved consideration as an alternative prophylactic agent to cephalothin for cardiac surgery.

Bacterial Infections↗
PubMed1979

Antibiotic use in a small community hospital.

Audits of medical records were done for similar one-month periods in 1974 and 1977 in a 125-bed community hospital in Hawaii to determine patterns of antibiotic use. One quarter of all hospital patients in both study periods received antibiotics. In 1977 cephalosporins, ampicillin and aminoglycosides were the most commonly used antibiotics. Half of the antibiotics used by surgical specialty departments in both periods were for prophylactic indications. The cost of antimicrobial prophylaxis per patient was reduced by about 57 percent in 1977 compared with 1974. In the 1977 period, 58 percent of patients received proper prophylactic antibiotic regimens; this was statistically higher than the 15 percent of patients given appropriate prophylactic antibiotics in 1974. Fewer than half of the patients in both study periods treated for infections received correct antibiotic therapy. In contrast, 82 percent of infectious disease consultations were considered appropriate by an independent specialist in infectious disease. However, these consultations were obtained in only 15 percent of the patients who received therapeutic antibiotics. It was concluded that audits of patients receiving antibiotics can be effective in the development of appropriate prophylactic surgical regimens. However, during the study period in 1977, we were not able to show large scale improvement in therapeutic antimicrobial use at this community hospital, either by our attempts at physician education or by making infectious disease consultations available.

Anti-Bacterial Agents↗
PubMed1978

Achromobacter xylosoxidans isolates in Hawaii.

Clinical and bacteriological features of nine cases in which Achromobacter xylosoxidans were isolated in Hawaii are described. Five cases were ear infections mixed with other gram-negative bacteria. Colonial morphology, xylose oxidation, peritrichous flagella staining, and antibiotic susceptibility pattern assisted in separating this bacterium from other nonfermentative, oxidase-positive, gram-negative rods.

Alcaligenes↗
PubMed1978

Primary antituberculous drug resistance in Hawaii, 1957 to 1977.

A study of primary antituberculous drug resistance in Hawaii was conducted from 1957 to 1977 to determine the incidence of primary resistance with respect to time. A total of 1,869 initial cultures of Mycobacterium tuberculosis submitted to Leahi Hospital in Honolulu were screened to identify drug resistance. Of 256 patients who excreted resistant bacilli, only 55 had no history of previous antituberculous chemotherapy. The frequencies of primary drug resistance from July 1957 to July 1977 were as follows: streptomycin, 0.86 per cent; isoniazid, 1.2 per cent; para-aminosalicylic acid, 1.5 per cent. No strains were resistant to ethambutol or rifampin. A slight decrease in the incidence of drug resistance during a 20-year period was observed. This was especially significant because Hawaii's tuberculosis problem is principally confined to its foreighn-born population. Although no serious primary drug resistance problem was discovered, Hawaii possesses both the highest immigration rate and the highest incidence of tuberculosis in the United states. Therefore, there is a need for continued periodic monitoring of drug resistance in Hawaii.

Aminosalicylic Acid↗
PubMed1978

Evaluation of primary plating media for the isolation of group A streptococcus from delayed throat cultures.

Sulfamethoxazole-trimethoprim blood agar (SXT-BA), neomycin blood agar (NEO-BA) and plain sheep blood agar plates (SBA) were compared for isolating group A streptococci in 1,954 throat cultures. SBA and SXT-BA had similar isolation rates (approximately 75% of all positive isolates). NEO-BA was significantly better (87% recovery). A combination of any two media gave 92-95% recovery of group A streptococci from throat specimens.

Adolescent↗
PubMed1977

Group VE-2 (Chromobacterium typhiflavum) bacteremia.

Group VE-2 (Chromobacterium typhiflavum) bacteremia occurred in a severely traumatized, post-neurosurgical patient. A discussion of the clinical occurrence of the organism, bacteriological characteristics, and antibiotic sensitivities is presented.

Adult↗