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Biomedical subjects

H C Neu

Publications and source records attributed to H C Neu.

At least 415 records · Page 23Linked to original sources
PubMed1976

Pharmacokinetics of cefamandole in the presence of renal failure in patients undergoing hemodialysis.

The pharmacology of cefamandole in seven patients with stable renal insufficiency and in eight patients undergoing hemodialysis was determined. All patients had creatinine clearances less than 5 ml/min. The half-life of cefamandole in those patients with stable chronic renal failure was 7.7 +/- 2.2 h. The mean venous level 1 h after intravenous injection of a 1-g dose was 85.3 +/- 32.0 mug/ml. The mean venous half-life of cefamandole during hemodialysis was 6.1 h. The venous serum level after 5.5 of hemodialysis was 50.4 +/- 20.8 mug/ml. The mean coefficient of extraction was 0.155, and the mean clearance was 34.7 ml/min. The time interval between doses of cefamandole administered intravenously should be lengthened to 24 h in the presence of stable renal failure. No major change in dosage schedule is necessary for patients undergoing dialysis.

Adult↗
PubMed1976

Comparison and evaluation of ticarcillin and carbenicillin using disk diffusion methods.

Ticarcillin has proved to be two- to fourfold more active than carbenicillin against most strains of Pseudomonas aeruginosa. Although susceptibility of the Enterobacteriaceae to ticarcillin could be predicted from results obtained with carbenicillin disks, neither the 50-mug nor the 100-mug carbenicillin disk proved suitable for testing susceptibility of P. aeruginosa to ticarcillin. Forty-three percent of Pseudomonas strains judged to be resistant to carbenicillin by the 100-mug carbenicillin disk were susceptible to ticarcillin by agar dilution studies. Results obtained with a 75-mug ticarcillin disk showed excellent correlation between zone size and ticarcillin minimal inhibitory concentration values and produced good discrimination between resistant and susceptible strains of Pseudomonas as determined by agar dilution studies. Using a 75-mug ticarcillin disk, a zone size of 12 to 14 mm was appropriate for designating intermediate susceptibility, and a zone greater than or equal to 15 mm was appropriate for designating susceptible strains of both P. aeruginosa and the Enterobacteriaceae.

Carbenicillin↗
PubMed1976

Beta-lactamase activity in Shigella sonnei.

The basis of ampicillin resistance in Shigella sonnei was analyzed for a number of isolates. Most isolates that were resistant to ampicillin and cephalothin failed to transfer resistance. Isolates resistant to cephalothin and ampicillin were inhibited by mecillinam, cefamandole, and cefoxitin. Six strains were selected for study. These differed on the basis of inhibition by 10 beta-lactam antibiotics and on differences in beta-lactamase activity. There was no correlation between the inhibitory concentration of antibiotic and the amount of antibiotic hydrolyzed. Use of sodium chloride and cloxacillin inhibition and acrylamide electrophoresis demonstrated that ampicillin resistance in Shigella is mediated by a number of different beta-lactamases. Organisms can contain more than one type of beta-lactamase.

Amidohydrolases↗
PubMed1976

Mecillinam, a novel penicillanic acid derivative with unusual activity against gram-negative bacteria.

The in vitro activity of mecillinam, a 6 beta-amidinopenicillanic acid derivative, was investigated. Mecillinam is not active against most gram-positive coccal or bacilliary forms. Many members of the Enterobacteriaceae are inhibited, with 86% of Escherichia coli, 71% of Klebsiella, 62% of Enterobacter, 75% of Salmonella, 69% of Shigella, and 70% of Citrobacter inhibited by 6.3 mug/ml. Indole-positive Proteus and Serratia were generally resistant as are Pseudomonas strains. Although mecillinam is hydrolyzed by gram-negative beta-lactamases, the compound inhibits beta-lactamase-producing organisms, particularly E. coli. The conductivity of medium used to determine minimal inhibitory concentration and inoculum size produce markedly different values. In medium of high conductivity, 10 mS, mecillinam is inactive against many strains of bacteria. In all media there is a great difference between the minimal inhibitory and minimal bactericidal levels.

Ampicillin↗
PubMed1976

The changing ecology of bacterial infections in children.

There is continued change in the organisms involved in commonly encountered infections. Although the major organisms have changed less in pediatric than in medical or surgical infections, the advances in neonatology and the chemotherapy of leukemia have resulted in cases in which infection with once uncommon organisms is now commonplace. Perhaps more disheartening has been the increasing resistance of bacteria to antibiotics. Since resistance patterns are so much a reflection of antibiotic usage patterns in an institution, each pediatrician must be aware of the species of bacteria and the resistance patterns of the bacteria isolated in his hospital, particularly in neonatal, intensive care, and burn areas where there is the highest use of antibiotics. Close interaction of pediatrician, diagnostic microbiology laboratory, and hospital epidemiologist can provide early clues to possible bacteria involved in infection, as well as suspected antibiotic resistance patterns.

Bacterial Infections↗
PubMed1975

Testing the physician's knowledge of antibiotic use: Self-assessment and learning via videotape.

Because recent reports suggest that physicians in the United States do not use antimicrobial agents properly, we analyzed scores for the first 4513 physicians viewing the National Antibiotic Therapy Test, a nationally televised self-assessment test on the diagnosis and treatment of infectious diseases. The 75-minute videotape test, produced by the Network for Continuing Medical Education, contained three section: a 10-question pre-test, a 25-question teaching test, and a 15-question post-test. Scores were tabulated according to the specialty, years in practice, and volume of patients seen. The mean correct score was 68 per cent for all 50 questions, 55 per cent for the 10 pre-test questions, and 71 per cent for the 15 post-test questions. Physicians in practice for one to five years, residents and internists scored better than other subgroups. Answers to questions indicated deficiencies of knowledge and the need for further postgraduate education in the use of antibiotics.

Anti-Bacterial Agents↗
PubMed1975

Meningitis, pneumonitis, and arthritis caused by Neisseria meningitidis group Y.

Neisseria meningitidis subgroup Y, although commonly isolated from the nasopharynx, rarely has caused meningitis in nonmilitary individuals. Meningococcus (serogroup Y) caused pneumonitis, meningitis, and arthritis in a previously healthy woman. Findings from examination of spinal fluid were minimal, but the clinical aspects of the illness were similar to those seen with other meningococcal serotypes.

Adult↗
PubMed1975

Antimicrobial resistance and R-factor transfer among isolates of Salmonella in the northeastern United States: a comparison of human and animal isolates.

The antimicrobial susceptibility of 718 isolates of Salmonella from humans and of 688 isolates from animals was examined. Of the 46 different serotypes among the isolates from humans, Salmonella typhimurium accounted for 34%. Thirty percent of isolates were resistant to one or more antibiotic(s). Resistance to streptomycin was most common; resistance to tetracycline was next most common. Over 50% of isolates of S. typhimurium and Salmonella newport were resistant to four antibiotics. Resistance to tetracycline, kanamycin, and ampicillin has increased steadily during the past decade. Most strains possessed R-factors, and resistance to ampicillin, streptomycin, sulfisoxazole, tetracycline, chloramphenicol, and kanamycin (but not that to cephalothin) was transferable. Among the salmonellae commonly isolated from humans, only Salmonella enteritidis showed limited resistance to antibiotics (5.8%). Antibiotic resistance of isolates of S. typhimurium, Salmonella saint-paul, and Salmonella heidelberg from animals was similar to the resistance of isolates from humans. Resistance to kanamycin increased markedly over the level noted in previous studies. R-factor prevalence was high. Antibiograms of the isolates from animals and humans were similar, although some patterns were seen only in isolates from one source. Ampicillin resistance was more common in human isolates, and resistance to tetracycline, sulfonamide, and streptomycin was more common in animal isolates. Salmonellae of serotypes other than S. typhimurium that came from humans were less resistant to all antibiotics than were isolates from animals.

Animals↗
PubMed1975

Comparative in vitro activity and clinical pharmacology of ticarcillin and carbenicillin.

The in vitro activity and human pharmacology of ticarcillin, a semisynthetic penicillin more active than carbenicillin against Pseudomonas, were compared. There has been no increase in resistance to ticarcillin of Pseudomonas strains over the past 5 years, but resistance of indole-positive Proteus and Serratia strains has been documented. After intramuscular (i.m.) injection of 1 g of ticarcillin, mean peak levels occurred at 1 h (26.9 mug/ml) with a decline over 6 h (6.8 mug/ml). Serum half-life was 84 min. Dilution of ticarcillin lidocaine reduced pain on i.m. injection but did not alter serum levels. Blood levels after 1 g i.m. are adequate to treat infections produced by Escherichia coli, Proteus mirabilis, and some Enterobacter, but not Pseudomonas. After rapid intravenous infusion of 3 and 5 g, mean peak serum levels of ticarcillin were slightly lower for 1 h than those achieved with carbenicillin. Probenecid administered before infusion produced increases in blood levels, half-lives, and volume of distribution. The biological half-life of ticarcillin was 72 min compared to 66 min with carbenicillin. There was a larger volume of distribution for ticarcillin than carbenicillin (15 liters versus 14 liters). The ticarcillin half-life when administered with probenecid was 108 min. Urinary recovery of ticarcillin was 77% against 95% of carbenicillin. However, approximately 10% of ticarcillin is recovered as penicilloic acid so that 95% of an intravenously administered dose is recovered.

Carbenicillin↗