Cefoxitin sodium: a clinical and pharmacological study.
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Biomedical subjects
Publications and source records attributed to H A Holt.
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A Staphylococcus aureus strain, resistant to aminoglycosides, including gentamicin and tobramycin, and to penicillin, lincomycin, and other antibiotics, caused an outbreak of hospital infection in a surgical ward which spread to the intensive-therapy unit and to two other hospitals. 21 patients were colonised and 9 of these had overt clinical infection. Administration of antibiotics to which the staphylococcus was resistant was associated with colonisation. The use of gentamicin, tobramycin, and lincomycin in these hospitals has increased as has the occurrence of bacterial resistance to these agents. An antibiotic policy to control their use is essential to preserve their value in life-threatening infections by bacteria resistant to other agents.
Carbenicillin or ticarcillin were incubated individually with each of the following antibiotics: gentamicin, tobramycin, sisomicin, amikacin. The residual activity of each aminoglycoside in this mixture was assayed enzymatically. Amikacin was inactivated the least of the aminoglycosides. Both penicillins inactivated each aminoglycoside to a similar extent by a degree which varied according to the medium of incubaiton, the least inactivation being seen in pooled human serum and the most in phosphate buffer at pH 7.4.
The use of high-voltage electrophoresis and bioautography for the separation mixtures of antibiotics received in clinical serum samples is described. The electrophoretic characteristics of 39 antibiotics are given as is the accuracy of the method for quantitating three antibiotics. In screening 189 consecutive serum samples submitted for routine antibiotic assay, undisclosed antibiotics were revealed by the technique in 35.