Biomedical subjects
Publications and source records attributed to I Roy.
Cephalothin, cefazolin, cephradine, and cefoxitin inhibited more than 75% of 326 anaerobic bacteria in vitro, but cefoxitin was the most effective against anaerobes in general and Bacteroides fragilis in particular.
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Effectiveness of cefsulodin in the treatment of urinary tract infections due to Pseudomonas aeruginosa was evaluated by means of a comparative study with 123 enrolled patients. Seventy-four patients whose therapy could be evaluated were randomly assigned to therapy with either cefsulodin at various dosages or an aminoglycoside (gentamicin, tobramycin, or amikacin). In all cases, the treatment course was five to 10 days (mean, 7.4 days), and levels of cefsulodin in the serum of patients administered the lowest dose (250 mg every 6 hr) exceeded the 90% minimal inhibitory concentration (MIC90) of cefsulodin for P. aeruginosa. Cefsulodin therapy cleared P. aeruginosa from 37 of 50 patients, and therapy with an aminoglycoside cleared P. aeruginosa from 16 of 24 patients. The rate of clearance was unrelated to the antibiotic used (cefsulodin, gentamicin, tobramycin, or amikacin) or to whether patients were catheterized, the infectious agent was resistant to carbenicillin or gentamicin or to 4 micrograms of cefsulodin/ml, or the level of cefsulodin in serum regularly exceeded the minimal bactericidal concentration (MBC) for the infecting strain. The mean MIC and MBC for strains isolated from patients who experienced relapse (failure) were not higher than the mean MIC and MBC for strains cleared by cefsulodin.
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Anaerobic bacteria, particularly the Bacteroides group, are becoming increasingly resistant to antimicrobials. Anaerobic susceptibility testing is often not done routinely in clinical laboratories, causing clinicians to depend on national survey results or susceptibility patterns published by different centers. In this study, we have determined anaerobic susceptibility patterns of 200 clinical isolates of anaerobic gram-negative bacilli from four hospitals in the inland countries of southern California (Inland Empire). Of 11 antibiotics tested, metronidazole and chloramphenicol were the most active, with no resistance noted, followed by imipenem, ticarcillin/clavulanate, and ampicillin/sulbactam. Among cephalosporins, cefoxitin was the most active and cefotetan the least. Significant differences in the susceptibility pattern to cefoxitin were observed in one hospital. Differences between our inland patterns and those for Los Angeles Wadsworth VA Hospital were seen for cefoxitin in the B fragilis group and piperacillin for B fragilis. We confirmed the National Committee for Clinical Laboratory Standards (NCCLS) recommendation for periodic determination of anaerobic susceptibility patterns. We also suggest that clinical laboratories routinely identify anaerobes to the species level to facilitate clinical application of in vitro results.