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Biomedical subjects

H C Neu

Publications and source records attributed to H C Neu.

At least 127 records · Page 7Linked to original sources
PubMed1988

Synergy of ciprofloxacin with fosfomycin in vitro against Pseudomonas isolates from patients with cystic fibrosis.

Pseudomonas aeruginosa remains the most common respiratory pathogen causing morbidity and mortality in cystic fibrosis (CF) patients. The in-vitro activity of ciprofloxacin and fosfomycin (calcium and tromethamine salts) in combination against P. aeruginosa isolates from CF patients, all of whom had received previous courses of ciprofloxacin, was evaluated by agar plate dilution chequerboard technique. The concentrations of drugs used were those that would be achieved in patients by oral and intravenous (fosfomycin only) routes. Synergy, taking into account fosfomycin concentrations achievable intravenously, was found against 60% of P. aeruginosa isolates. With concentrations achieved after an oral dose, 17% of isolates were synergistically inhibited. Time-kill experiments confirmed these findings. Ciprofloxacin MICs against resistant P. aeruginosa were reduced to achievable sputum and serum levels in the presence of fosfomycin. However, in progressive resistance studies fosfomycin failed to delay the development of resistance to ciprofloxacin. The combinations of ofloxacin/fosfomycin and ciprofloxacin/fosmidomycin were also tested, but showed minimal synergy. No antagonism was observed with any combination. Fosfomycin, ciprofloxacin and azlocillin in triple combination did not show synergy. The antimicrobial combinations tested against P. cepacia isolates from CF patients were indifferent. The combination of ciprofloxacin and fosfomycin may be clinically useful in selected P. aeruginosa pulmonary exacerbations in cystic fibrosis patients, particularly as an oral out-of-hospital treatment alternative or in cases where MICs for ciprofloxacin are elevated.

Ciprofloxacin↗
PubMed1988

In-vitro activity and beta-lactamase stability of LY163892.

LY163892 is a new orally absorbed carbacephem. It inhibited Streptococcus pyogenes and Str. pneumoniae at less than or equal to 1 mg/l, but was less active against group B streptococci and groups C, F, G and bovis streptococci with MICs of 1 to 2 mg/l for most but as high as 8 mg/l for some isolates. MIC90 of methicillin-susceptible Staphylococcus aureus was 8 mg/l, but greater than 128 mg/l for methicillin-resistant staphylococci. LY163892 had activity similar to cefaclor and cephalexin with MIC90 values of 16 mg/l for Escherichia coli, 8 mg/l for Klebsiella pneumoniae, Proteus mirabilis, Yersinia enterocolitica, but was more active against Haemophilus influenzae, and Branhamella catarrhalis. It had no activity against Enterobacter, Providencia, Serratia, and Pseudomonas and Bacteroides spp. LY163892 was more rapidly lytic than cephalexin. It was hydrolyzed by a number of plasmid and chromosomal beta-lactamases. For TEM-1, the Km = 354.7 microM, Vmax = 2.5 microMoles/min/mg of protein, P99 Km = 24.3 microM, Vmax = 28.9 microM/min/micrograms of protein, Staph. aureus PC Km = 47.4 microM, Vmax = 2.7 microMoles/min/mg of protein. Overall it had beta-lactamase stability similar to cefaclor, less than cephalexin, and markedly less than cefuroxime.

Amoxicillin↗
PubMed1988

Tigemonam, an oral monobactam.

Tigemonam is an orally administered monobactam. At less than or equal to 1 microgram/ml it inhibited the majority of strains of Escherichia coli, Klebsiella spp., Enterobacter aerogenes, Citrobacter diversus, Proteus spp., Providencia spp., Aeromonas hydrophila, Salmonella spp., Shigella spp., Serratia marcescens, and Yersinia enterocolitica. At less than or equal to 0.25 microgram/ml it inhibited Haemophilus spp., Neisseria spp., and Branhamella catarrhalis. It did not inhibit Pseudomonas spp. or Acinetobacter spp. Tigemonam was more active than cephalexin and amoxicillin-clavulanate and inhibited many members of the family Enterobacteriaceae resistant to trimethoprim-sulfamethoxazole and gentamicin. Some Enterobacter cloacae and Citrobacter freundii strains resistant to aminothiazole iminomethoxy cephalosporins and aztreonam were resistant to tigemonam. The MIC for 90% of hemolytic streptococci of groups A, B, and C and for Streptococcus pneumoniae was 16 micrograms/ml, but the MIC for 90% of enterococci, Listeria spp., Bacteroides spp., and viridans group streptococci was greater than 64 micrograms/ml. Tigemonam was not hydrolyzed by the common plasmid beta-lactamases such as TEM-1 and SHV-1 or by the chromosomal beta-lactamases of Enterobacter, Morganella, Pseudomonas, and Bacteroides spp. Tigemonam inhibited beta-lactamases of E. cloacae and Pseudomonas aeruginosa but did not induce beta-lactamases. The growth medium had a minimal effect on the in vitro activity of tigemonam, and there was a close agreement between the MICs and MBCs.

Administration, Oral↗
PubMed1988

In vitro activity of E-1040, a novel cephalosporin with potent activity against Pseudomonas aeruginosa.

The in vitro activity of E-1040 [(6R,7R)-3-[(4-carbamoyl-1-quinuclidinio)methyl]-7-[2-(5-amino-1,2 ,4- thiadiazol-3-yl)-(Z)-2-methoxyiminoacetoamido]-8-oxo-5-thia- 1- azabicyclo(4,2,0)oct-2-ene-2-carboxylate], a novel cephalosporin, was compared with that of ceftazidime, cefpirome, cefepime, imipenem, and gentamicin. E-1040 inhibited 50% of members of the family Enterobacteriaceae, Pseudomonas aeruginosa, and Haemophilus and Neisseria species at less than or equal to 0.25 microgram/ml, and the MIC for 90% of strains tested ranged from 0.06 to 2 micrograms/ml. It was two- to fourfold more active than ceftazidime and similar in activity to cefepime and cefpirome. It inhibited Enterobacter, Citrobacter, Serratia, and Morganella species that were resistant to ceftazidime. E-1040 inhibited imipenem-, piperacillin-, aztreonam-, and tobramycin-resistant P. aeruginosa. It was less active against Xanthomonas maltophilia and P. cepacia but inhibited other Pseudomonas species. The activity of E-1040 against staphylococci and hemolytic streptococci was similar to that of ceftazidime, but E-1040 was less active than cefepime and cefpirome. It did not inhibit Bacteroides spp. There was no inoculum effect or medium effect, and MBCs were within a dilution of MICs. Plasmid beta-lactamases TEM-1, TEM-2, TEM-3 (CTX-1), SHV-1, Staphylococcus aureus, PSE, and CARB did not hydrolyze E-1040. Chromosomal beta-lactamases P99 and K-1 did not hydrolyze E-1040; E-1040 had poor affinity for these enzymes, with a Ki of greater than 100 microM.

Aminoglycosides↗
PubMed1988

In vitro activities of two oxazolidinone antimicrobial agents, DuP 721 and DuP 105.

The antibacterial activities of DuP 105 and DuP 721, new oxazolidinone antimicrobial agents, were compared with those of beta-lactams and glycopeptides. Ninety percent of Staphylococcus aureus and Staphylococcus epidermidis isolates, including methicillin-resistant isolates, were inhibited by 4 micrograms of DuP 105 and 1 microgram of DuP 721 per ml. DuP 721 inhibited hemolytic streptococcus groups A, B, C, F, and G at a concentration of less than or equal to 1 microgram/ml, and it inhibited viridans group streptococci at a concentration of 2 micrograms/ml. Both agents inhibited Listeria monocytogenes, Corynebacterium group JK species, anaerobic cocci, and Clostridium spp. including Clostridium difficile. They did not inhibit members of the family Enterobacteriaceae or Pseudomonas aeruginosa, but the MIC for 90% of Bacteroides fragilis isolates was 8 micrograms of DuP 721 per ml.

Anti-Bacterial Agents↗
PubMed1988

In vitro activity of lomefloxacin (SC-47111; NY-198), a difluoroquinolone 3-carboxylic acid, compared with those of other quinolones.

Lomefloxacin (SC-47111; NY-198) is a new difluoroquinolone agent. It inhibited 90% of Escherichia coli, Klebsiella spp., Enterobacter spp., Citrobacter spp., Proteus mirabilis, Morganella morganii, Proteus vulgaris, Serratia marcescens, Salmonella spp., Shigella spp., Aeromonas spp., Yersinia spp., Haemophilus influenzae, and Neisseria gonorrhoeae at less than or equal to 2 micrograms/ml. Lomefloxacin inhibited 90% of Pseudomonas aeruginosa at 4 micrograms/ml. Lomefloxacin was equal in activity to norfloxacin against Escherichia coli, Klebsiella spp., Enterobacter spp., Haemophilus influenzae, and Neisseria gonorrhoeae but was twofold less active against Proteus spp., Providencia spp., Serratia marcescens, Salmonella spp., and Shigella spp. Ofloxacin was generally 2- to 4-fold more active, and ciprofloxacin was 4- to 16-fold more active. Lomefloxacin inhibited Staphylococcus aureus, including methicillin-resistant isolates, but MICs for 90% of streptococcal species tested were 8 micrograms/ml. In the presence of 9 mM Mg2+, MICs for Escherichia coli, Klebsiella pneumoniae, Serratia marcescens, and Pseudomonas aeruginosa were increased, as they were when they were tested in urine. A single-step increase in resistance to eightfold above the MIC occurred at a frequency of less than 10(-10), but serial transfer of bacteria in the presence of the agent produced MIC increases. Lomefloxacin had activity and properties comparable to those of many of the new quinolones.

Anaerobiosis↗
PubMed1988

Comparative in vitro activity of a new fluorinated 4-quinolone, T-3262 (A-60969).

The in vitro activity of a new quinolone, T-3262 [A-60969; DL-7-(3-amino-1-pyrrolidinyl)-1-(2,4-difluorophenyl)-6-fluoro-1-, 4-dihydro-4-oxo-1,8-naphthyridine-3-carboxylic acid monohydrate], was compared with those of ciprofloxacin, ofloxacin, ceftazidime, imipenem, and gentamicin. T-3262 inhibited 90% of isolates of the family Enterobacteriaceae at a concentration of less than or equal to 0.25 micrograms/ml. It was two to four times more active than ofloxacin and similarly or slightly less active than ciprofloxacin. Ninety percent of isolates of Pseudomonas aeruginosa were inhibited at 0.5 micrograms/ml. It was 4- to 8-fold more active than ciprofloxacin and 8- to 16-fold more active than ofloxacin against Pseudomonas cepacia and Pseudomonas maltophilia, which were resistant to imipenem and gentamicin. Most Haemophilus influenzae, Neisseria gonorrhoeae, and Branhamella catarrhalis isolates were inhibited at concentrations of less than or equal to 0.008 micrograms/ml. The MIC for 90% of the Staphylococcus aureus isolates, including methicillin-resistant S. aureus, was 0.12 micrograms/ml; that for Staphylococcus epidermidis was 0.5 micrograms/ml, as was that for Enterococcus faecalis. It inhibited 90% of Bacteroides fragilis isolates at 2 micrograms/ml, considerably more active than ciprofloxacin and ofloxacin. The frequency of spontaneous point mutational resistance was less than 10(-10) for members of the family Enterobacteriaceae and Pseudomonas spp. Resistant strains could be selected by repeated subculture. Similar to other quinolones, its activity could be affected by culture conditions. T-3262 showed a postantibiotic suppressive effect on Escherichia coli, P. aeruginosa, and S. aureus.

Anti-Bacterial Agents↗
PubMed1988

In vitro activity of an oral iminomethoxy aminothiazolyl cephalosporin, R-3746.

The in vitro activity of R-3746, an iminomethoxy aminothiazolyl cephalosporin with a CH2OCH3 moiety at position 3, was compared with those of other antibiotics. R-3746 inhibited the majority of hemolytic streptococci (groups A, B, C, F, and G) and Streptococcus pneumoniae at less than 0.06 micrograms/ml, which was comparable to the activity of amoxicillin, 2- to 8-fold more active than cefixime, and 16- to 64-fold more active than cefaclor and cephalexin. Ninety percent of beta-lactamase-producing Haemophilus influenzae and Neisseria gonorrhoeae were inhibited at a concentration 0.25 micrograms/ml, but it was less active against Branhamella spp. It did not inhibit (MIC, greater than 16 micrograms/ml) enterococci, viridans group streptococci, or methicillin-resistant staphylococci. The MICs of R-3746 for 90% of strains tested for Escherichia coli; Klebsiella pneumoniae; Citrobacter diversus; Proteus mirabilis; and Salmonella, Shigella, and Yersinia spp. were less than or equal to 1 micrograms/ml. It was two- to eightfold less active than cefixime but was markedly superior to cefaclor, cephalexin, amoxicillin-clavulanate, and trimethoprimsulfamethoxazole. R-3746 inhibited 50% of Enterobacter cloacae, Enterobacter aerogenes, Citrobacter freundii, Morganella spp., Providencia spp., Proteus vulgaris, and Serratia marcescens at less than or equal to 8 micrograms/ml. Pseudomonas spp. were resistant. Fifty percent of Clostridium spp. were inhibited by 0.5 micrograms/ml, but MICs for Bacteroides spp. were greater than 128 micrograms/ml. R-3746 was not appreciably hydrolyzed by most chromosomal and plasmid-mediated beta-lactamases.

Amoxicillin↗
PubMed1988

Beta-lactamase inhibition by acetylmethylene penicillanic acid compared to that of clavulanate and sulbactam.

The beta-lactamase inhibitory properties of 6-acetylmethylene penicillanic acid (6-AMPA) were investigated and compared with those of other beta-lactamase inhibitors. 6-AMPA inhibited the TEM-1, TEM-2, SHV-1, PSE-1, PSE-2, PSE-3, PSE-4, OXA-2, OXA-3, and Staphylococcus aureus beta-lactamases. It also inhibited the chromosomally-mediated beta-lactamases of the Richmond-Sykes type Ia, Ic and Id type and the type IV Klebsiella enzymes. Beta-lactamases of Branhamella catarrhalis and Bacteroides fragilis were inhibited. The 6-AMPA I50 values for various enzymes were less than 0.01 microgram/ml TEM-1 and PSE-4, and 0.01 microgram/ml SHV-1, 0.02 microgram/ml S. aureus, 0.04 microgram/ml Proteus vulgaris, 0.04 microgram/ml K. oxytoca, 6.8 micrograms/ml P99, and 9.7 micrograms/ml Sabath-Abraham Pseudomonas enzyme. With isolated beta-lactamases 6-AMPA was a more potent inhibitor than clavulanate or sulbactam. 6-AMPA was an irreversible inhibitor of beta-lactamases. The penetration index for Escherichia coli JT4 was 23 compared to 3 for clavulanate. 6-AMPA at 10 micrograms/ml acted synergistically with ampicillin against beta-lactamase containing bacteria, but it was less active than clavulanate and did not act synergistically with ampicillin against Enterobacter, Citrobacter or Pseudomonas. Although 6-AMPA has excellent beta-lactamase inhibitory properties with isolated enzymes, it is less useful with intact organisms.

Bacteria↗
PubMed1987

Ciprofloxacin therapy in cystic fibrosis.

There is great need for an oral agent that could be used to treat pulmonary exacerbations in patients with cystic fibrosis. In this study, the use of oral ciprofloxacin as sole therapy was evaluated in 18 patients with 39 infectious episodes; 13 episodes were classified as severe, 19 were classified as moderate, and seven were classified as mild. Patients ranged in age from eight to 36 years (mean, 23 years). Dosage varied according to severity of disease, body size, and the susceptibility of the Pseudomonas isolate to ciprofloxacin; the dose ranged from 750 to 2,250 mg daily (mean, 1,800 mg). Ten patients received one course of ciprofloxacin, and eight received repeated courses. The overall clinical response rate was 82 percent. There was a response to the initial treatment course in 96 percent of the patients. Those in whom therapy failed had been re-treated with ciprofloxacin and were severely ill. Failure to respond correlated poorly with pretreatment minimal inhibitory concentration (MIC) values (0.6 microgram/ml for failures versus 0.4 microgram/ml for responses). Pseudomonas could not be eradicated from the sputum of any of the patients, although there was a marked reduction in purulence and bacterial counts. In general, patients who did not require re-treatment for three months would again have susceptible organisms. When organisms became resistant to ciprofloxacin (MIC greater than 2 micrograms/ml), they showed no concomitant new aminoglycoside or beta-lactam resistance. No serious toxicity occurred in any of the 39 episodes of treatment. In seven patients treated with combination therapy (tobramycin or azlocillin), the infecting organisms were reduced in number, but eradication of Pseudomonas generally could not be achieved. Increases in MIC occurred during combination therapy. Ciprofloxacin is a major advance in the treatment of bronchopulmonary infection in patients with cystic fibrosis.

Adolescent↗
PubMed1987

Treatment of serious infections with intravenous ciprofloxacin.

Thirty-four patients were treated with intravenous ciprofloxacin. Thirty infections occurring in 28 patients were assessable for the efficacy analysis. The drug dosage was 300 mg every 12 hours in 19 patients and 200 mg intravenously every 12 hours in nine patients. Twelve patients were also given ciprofloxacin orally after initial intravenous therapy. The mean duration of total therapy was 31 days. The overall clinical response rate was 87 percent, and the bacteriologic response rate was 70 percent. Favorable responses were observed in 10 of 12 patients with osteomyelitis/septic arthritis; seven of eight with soft tissue infection; four of four with pneumonitis; one of two with cystic fibrosis; and four of four with urinary tract infections. Resistance to ciprofloxacin developed in three Pseudomonas aeruginosa isolates. Toxicity was minor: phlebitis occurred in six patients, nausea in six, and rash in one. Intravenously administered ciprofloxacin or intravenous ciprofloxacin followed by oral ciprofloxacin is a safe and effective therapy for serious infections.

Administration, Oral↗
PubMed1987

Effect of ciprofloxacin on fecal flora of patients with cystic fibrosis and other patients treated with oral ciprofloxacin.

Ciprofloxacin is a fluorinated carboxyquinolone that inhibits Enterobacteriaceae, staphylococci, and Pseudomonas at low concentrations. It has poor activity against Bacteroides fragilis. In this study, the effect of administration of ciprofloxacin on bowel flora was determined in patients treated for different infections. Patients, aged 22 to 70 years, were treated with 500 mg of ciprofloxacin every 12 hours or 750 mg every eight hours for seven to 42 days. Some patients had advanced cystic fibrosis; other patients had infections with resistant bacteria. Infecting organisms were Pseudomonas aeruginosa, Staphylococcus aureus, Serratia, and Acinetobacter. Sites of infections were lung, soft tissue, and urinary tract. Stool samples were evaluated initially, during therapy, and after therapy. No resistant gram-negative aerobic species emerged; five patients had yeast colonization, staphylococci were found in three patients, and streptococci were found in one patient. Ciprofloxacin did not select resistant gram-negative bacteria in the stool, although sputum isolates showed increases in minimal inhibitory concentrations. Resistant bacteria were not selected in the fecal flora of patients who had received beta-lactam and aminoglycoside antibiotics before therapy with ciprofloxacin.

Administration, Oral↗