Search PubMed⌕ Search

Biomedical subjects

H Kusmiesz

Publications and source records attributed to H Kusmiesz.

26 records · Page 2Linked to original sources
PubMed1976

Comparison of trimethoprim-sulfamethoxazole and ampicillin theraphy for shigellosis in ambulatory.

One-hundred seventy-four infants and children with acute diarrhea were treated as ambulatory patients with either ampicillin (100 mg/kg/day orally in four divided doses) or trimethoprim sulfamethoxazole (10 mg TMP and 50 mg SMX/KG/day orally in two divided doses). There were 65 patients with shigellosis. Responses of those treated with TMP/SMX and of those with susceptible Shigella treated with ampicillin were comparable. Patients with resistant organisms failed to respond to ampicillin. All Shigella, including ampicillin-resistant strains, were suseptible in vitro to TMP/SMX, and patients with ampicillin-resistant strains responded favorably to treatment with TMP/SMX. TMP/SMX appears to be the best, currently available drug for the treatment of shigellosis.

Ambulatory Care↗
PubMed1975

Clinical pharmacology of ticarcillin in the newborn infant: relation to age, gestational age, and weight.

Ticarcillin, a new penicillin derivative with greater in vitro activity against Pseudomonas than carbenicillin, was given as a single dose of 50 mg/kg intramuscularly on 61 occasions to 54 neonates and young infants. The serum concentrations and rate of elimination varied considerably depending upon gestational age, chronological age, and body weight. Peak serum concentrations depended principally upon the volume of distribution which approximated the extracellular fluid volume of the neonate. The plasma clearance and serum half-life of the drug were determined. From these pharmacokinetic data appropriate groupings according to age and body weight were made and dosages and intervals of administration predicted for clinical trials of efficacy with repeated doses.

Age Factors↗
PubMed1972

Pharmacokinetics of carbenicillin in neonates of normal and low birth weight.

A single intramuscular dose of 100 mg carbenicillin/kg produced measured peak concentrations of approximately 150 to 175 mug/ml in newborn infants. The carbenicillin serum half-life of 1.0 hr in normal adults was prolonged to 2.7 hr in infants of normal birth weight and to 4.0 hr in babies of low birth weight in the first week of life. One-third of a dose administered to babies of low birth weight and two-thirds of that given to babies weighing over 2,500 g was excreted by the kidney in 12 hr. Postadministration 6-hr urinary carbenicillin concentrations averaged 1,399 mug/ml after an intramuscular dose of 50 mg/kg and 2,689 mug/ml after a 100 mg/kg injection. Although carbenicillin is excreted by both glomerular and tubular mechanisms in adults, serum half-life and urinary carbenicillin excretion correlated well with creatinine clearance. Recommendations for dosage of carbenicillin and intervals of administration in the neonatal period are made based upon mathematical predictions from pharmacokinetic data.

Anti-Bacterial Agents↗
PubMedDate not supplied

Oral or intravenous trimethoprim-sulfamethoxazole therapy for shigellosis.

A review of the literature concerning shigellosis treated with trimethoprim-sulfamethoxazole (TMP-SMZ) revealed comparative studies of 149 cases and noncomparative studies of 147 cases. Bacteriologic and clinical success rates were greater than or equal to 90% and TMP-SMZ compared favorably with alternative drug therapy. In the present study TMP-SMZ was given intravenously as initial therapy to 11 children hospitalized for severe shigella colitis. Bacteriologic and clinical responses were comparable to those observed with oral TMP-SMZ therapy. Pharmacokinetic studies revealed substantial differences between the responses of these children and those reported for adult patients; a higher ratio of SMZ to TMP (50:1) was found in children. It is concluded that TMP-SMZ is effective therapy for shigellosis and is the drug of choice in areas where ampicillin resistance is prevalent.

Administration, Oral↗
PubMedDate not supplied

Cefuroxime therapy for pneumonia in infants and children.

Because Streptococcus pneumoniae, Haemophilus influenzae b and Staphylococcus aureus are the major causes of bacterial pneumonia in infancy, we customarily have given a beta-lactam antibiotic and chloramphenicol as initial antibiotic therapy. Cefuroxime (75 mg/kg/day divided every 8 hours iv or im) was evaluated as single drug therapy in an open study of 100 infants and children with suspected bacterial pneumonia. The mean serum concentration of cefuroxime 30 minutes after a 15-minute infusion of 25 mg/kg iv was 29.1 micrograms/ml, and the volume of distribution was 695 ml/kg. Pleural fluid concentrations in 3 specimens were 2.2, 8.5 and 11 micrograms/ml. Median age of patients was 15 months. Bacterial etiology was established in 20 patients: H. influenzae b (8 patients); pneumococcus (8 patients); S. aureus (2 patients); Group A streptococcus (1 patient); Neisseria meningitidis B (1 patient). All organisms were susceptible to 1.25-micrograms/ml doses or less of cefuroxime. The mean number of days was 3.1 until patients became afebrile and 5.1 until respiratory symptoms were gone. Eosinophilia occurred in 10 patients. Cefuroxime is safe and effective single drug therapy for pneumonia in infants and children.

Cefuroxime↗
PubMedDate not supplied

Pharmacologic interactions among chloramphenicol, phenytoin and phenobarbital.

Bioactive chloramphenicol was measured in the sera of 34 infants and children receiving intravenous chloramphenicol succinate (25 mg/kg/dose) as therapy for meningitis, pneumonia, brain abscess or Rocky Mountain spotted fever. In 17 children receiving chloramphenicol succinate alone, mean peak and trough serum concentrations of chloramphenicol were 25.3 and 13.4 micrograms/ml, respectively. Concurrent administration of chloramphenicol succinate and phenobarbital in six patients resulted in reduced peak and trough concentrations of chloramphenicol of 16.6 and 7.5 micrograms/ml, respectively (P less than 0.05). Concurrent administration of chloramphenicol succinate and phenytoin in six patients resulted in an elevated mean peak serum concentration of chloramphenicol of 41.7 micrograms/ml (P less than 0.05). Five other patients treated with phenytoin had indeterminate serum chloramphenicol half-lives with chloramphenicol concentrations of 29 to 90 micrograms/ml. Potentially toxic chloramphenicol concentrations occurred in 9 of 17 controls, 0 of 6 patients who had received phenobarbital (P = 0.001) and 11 of 11 patients who had received phenytoin (P = 0.008). Patients receiving combined chloramphenicol succinate and anticonvulsant therapy require monitoring of serum concentrations of drug and adjustments in the dose of chloramphenicol succinate administered.

Biological Availability↗
PubMedDate not supplied

Comparison of piperacillin vs. ticarcillin plus tobramycin in the treatment of acute pulmonary exacerbations of cystic fibrosis.

During a 22-month period 35 children with cystic fibrosis received 52 courses of antibiotic therapy for acute pulmonary exacerbations, including 26 cases of therapy with piperacillin and 26 courses with ticarcillin plus tobramycin. Groups were similar in age (5 vs. 5.4 years), disease severity based on Schwachman scores and presenting symptoms. Pseudomonas aeruginosa was the most common organism isolated in 90% of sputum cultures. Mean minimal inhibitory concentrations for piperacillin, ticarcillin and tobramycin were 8, 64 and 1 microgram/ml, respectively. Piperacillin pharmacokinetic data revealed an average half-life in serum of 36 minutes. Peak serum concentrations averaged 144 micrograms/ml, and after 4 hours serum concentrations continued to exceed the P. aeruginosa 90% minimal inhibitory concentration in 50% of children. The dosage requirement for tobramycin was quite variable, necessitated monitoring of aminoglycoside serum concentrations and in most cases resulted in at least one dosage adjustment. Emergence of resistant bacteria was not seen in 26 courses of piperacillin therapy. Both regimens were effective and well-tolerated. Single agent therapy has the advantage of providing reliable serum concentrations and, in contrast to the standard therapy, does not necessitate monitoring of serum drug concentrations.

Acute Disease↗