Search PubMed⌕ Search

Biomedical subjects

I Phillips

Publications and source records attributed to I Phillips.

At least 217 records · Page 12Linked to original sources
PubMed1983

The impact of antibiotic policy on prescribing in a London teaching hospital. A one-day prevalence survey as an indicator of antibiotic use.

To assess current antibiotic use and the impact on prescribing of hospital antibiotic policy, a prospective one-day prevalence survey of antibiotic use in both in-patients and out-patients was undertaken at St Thomas' Hospital. Of 921 in-patients, 196 (21%) received 269 antibiotic prescriptions on the survey day. Approximately 40% of in-patients received prophylaxis and 60% received treatment. Among 1521 out-patients, 292 (19%) were given a prescription on the survey day and 102 (7%) received an antibiotic prescription. Assessment of in-patient use with reference to the current hospital antibiotic policy was made mainly on microbiological grounds, on choice and dosage of agents. Choice of antibiotic was largely in accord with antibiotic policy, but was considered inappropriate in 12.5% of 81 in-patients given prophylaxis and 2.5% of 120 in-patients given treatment. Dosage of some major agents and timing of surgical prophylaxis was also considered inappropriate in many patients. A simple one-day survey is a useful indicator of antibiotic use in the hospital, and shows where further guidance to prescribers could be provided.

Anti-Bacterial Agents↗
PubMed1983

Cefotetan: in-vitro antibacterial activity and susceptibility to beta-lactamases.

The in-vitro antibacterial activity of cefotetan was assessed against recent clinical isolates of common bacteria and also against reference strains that produced known beta-lactamases. The compound was active against most staphylococci (MICs 4 to 8 mg/l) though methicillin-resistant strains were less sensitive. It was also generally active against streptococci (MICs mostly in the range 1 to 16 mg/l). However, enterococci and penicillin-resistant pneumococci were resistant. Cefotetan was highly active against enterobacteria, with 75% of isolates inhibited by 0.5 mg/l and 90% inhibited by 4 mg/l. It was also highly active against Haemophilus influenzae (MICs 0.5 to 4 mg/l) and Neisseria gonorrhoeae (MICs 0.06 to 2 mg/l) but had relatively poor activity against Acinetobacter spp. (MICs mostly 4 to 128 mg/l). Cefotetan had little useful activity against Pseudomonas aeruginosa (MICs 16 to 512 mg/l) but was more active against most other pseudomonads. Cefotetan had moderate activity against the Bacteroides fragilis group (MICs mostly less than or equal to 32 mg/l), though Bact. fragilis sensu stricto and Bact. vulgatus were more sensitive (MICs usually less than or equal to 4 mg/l). It was more active against most other anaerobes, though its activity was always exceeded by that of ampicillin. Cefotetan possessed a high degree of resistance to both plasmid-mediated and chromosomally-determined beta-lactamases.

Anti-Bacterial Agents↗
PubMed1983

Reduced sensitivity to beta-lactam antibiotics arising during ceftazidime treatment of Pseudomonas aeruginosa infections.

Pseudomonas aeruginosa isolated from two patients with empyema and one with bronchopneumonia became less sensitive after treatment with ceftazidime, while Ps. aeruginosa persisted in a patient with an infected compound fracture of the tibia treated with ceftazidime but did not become less sensitive. The reduction in sensitivity to ceftazidime, which was small, was accompanied by resistance to azlocillin but there are little reduction in sensitivity to carbenicillin. The resistant strains produced increased amounts of the chromosomally-mediated cephalosporinase produced by most isolates of Ps. aeruginosa. Variants with reduced sensitivity to ceftazidime, which resembled those that developed in vivo, were selected in vitro from each of the initial ceftazidime-sensitive isolates.

Adult↗
PubMed1983

The identification of Gardnerella vaginalis.

A collection of 72 strains of catalase-negative gram-positive, -negative and -variable cocco-bacilli isolated from samples of vaginal discharge from women with non-specific vaginal infection was examined in an attempt to develop an identification system for Gardnerella vaginalis that could be used in a diagnostic laboratory. Carbohydrate fermentation tests were found to be poorly reproducible and of little differentiating value. Enzyme tests were found similarly unhelpful, as were many antibiotic-susceptibility and chemical-inhibition tests. However, seven tests--susceptibility to trimethoprim and two concentrations of metronidazole, growth in the presence of 2% (w/v) sodium chloride and on nutrient agar, lactic acid production from glucose and beta-haemolysis on human-blood agar--were used successfully in this study to separate G. vaginalis from catalase-negative coryneforms and lactobacilli. Of these tests, susceptibility to trimethoprim and metronidazole together with beta-haemolysis on human blood agar are the most likely to provide a rapid, accurate identification. A possible identification scheme is outlined.

Carbohydrate Metabolism↗
PubMed1983

Imported penicillinase producing Neisseria gonorrhoeae becomes endemic in London.

We review all cases of gonorrhoea caused by penicillinase producing Neisseria gonorrhoeae (PPNG) seen between 1976 and 1983 at the sexually transmitted disease (STD) clinic of this hospital, which accounted for 11% of all such cases reported in that period in the United Kingdom. While the overall incidence of gonorrhoea remained relatively stable in this clinic, that of PPNG rose to 4.4% of all such cases by 1982. Until last year, 75% of these cases were imported, mainly from Nigeria and Ghana, but a marked change was seen in the second half of 1982, when 71% of cases were indigenous in origin. Casual partners and prostitutes in London were mentioned as the source of infection by 34% of patients, a much higher percentage than that seen previously. Such sources are notoriously difficult to trace and these figures show a very disturbing trend. Although rectal infection tends to be asymptomatic, PPNG was isolated in rectal cultures from two of five homosexuals and 19 of 26 women. There is therefore a risk that PPNG could spread rapidly through the homosexual population. We suggest that spectinomycin should no longer be the first drug of choice in the treatment of gonorrhoea caused by PPNG but should be replaced by the newer cephalosporins.

Africa, Western↗
PubMed1983

Metronidazole in treatment of non-specific vaginitis. Clinical and microbiological findings in ten patients given 2 grams of metronidazole.

A 2 gram single dose of metronidazole was given to ten patients suffering from nonspecific vaginitis. At follow-up a week later seven of these patients were clinically and microbiologically free from infection. The remaining three patients had persisting symptoms and both clinical and microbiological findings confirmed treatment failure. Despite the small numbers entered into the trial to date, a cure rate of only seven out of ten patients suggests that a 2 gram single dose of metronidazole is inadequate treatment for non-specific vaginitis.

Bacterial Infections↗
PubMed1982

Synthesis of rat muscle carbonic anhydrase III in a cell-free translation system.

Carbonic anhydrase III (CA III) was identified in the products of rat soleus muscle RNA translation in vitro by both a radioimmunoassay and a specific immunoprecipitation technique followed by SDS--polyacrylamide gel electrophoresis analysis of the precipitated antigen. The primary translation product has the same Mr-value as the native isoenzyme. CA III mRNA was found to represent approximately 0.55% of the total mRNA present in rat soleus muscle.

Animals↗
PubMed1982

Ceftazidime--a new extended-spectrum cephalosporin.

65 patients with serious infections, including 25 with septicaemia, were treated with ceftazidime, a new extended-spectrum cephalosporin. 80% of the infection were cured by the antibiotic. 11 of 12 infected patients who had malignant disease or were otherwise immunocompromised responded satisfactorily to ceftazidime; 7 of these 12 had infections caused by Pseudomonas aeruginosa. The serum half-life of ceftazidime was 1.9 h in a patient with normal renal function. After a 1 g intravenous dose the antibiotic was present in pus, sputum, and bile in therapeutic concentrations. The antibiotics should prove a useful and non-toxic alternative to the aminoglycosides.

Adolescent↗
PubMed1982

The aetiology of perirectal sepsis.

Organisms that are present in the normal faecal flora, especially Bacteroides fragilis, were isolated significantly more often from perirectal abscesses associated with a fistula. Other organisms similar to those associated with infection of obstructed apocrine glands at other sites were isolated from abscesses without fistulas. These findings suggest that perirectal abscesses with and without fistulas may have a different aetiology and that appropriate bacteriological investigation may give an indication of the presence of an unsuspected fistula and thus provide useful guidance to the correct surgical management of the patient. Staphylococcus aureus and other skin organisms were found less frequently than in previous studies on perirectal sepsis and were equally common in cases with or without a fistula-in-ano.

Abscess↗
PubMed1982

The aetiology of scrotal sepsis.

The clinical findings and bacteriology of 30 abscesses of the scrotum and described. Anaerobic organisms were found in 27 abscesses (90 per cent), and in 3 cases in which they were not, the patients were receiving metronidazole at the time of drainage. Multiple anaerobic species were isolated, predominantly those found as commensals in the oropharynx and genital tract. "Gut specific' Bacteroides spp. were very uncommon and were found only in patients with necrotizing fasciitis. It is suggested that the severity of some infections, particularly after scrotal surgery, is associated with thrombosis of the scrotal vessels.

Abscess↗