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Biomedical subjects

J L LeFrock

Publications and source records attributed to J L LeFrock.

At least 19 recordsLinked to original sources
PubMed1992

Teicoplanin in the treatment of bone and joint infections. Teicoplanin Bone and Joint Cooperative Study Group, USA.

Teicoplanin is a new glycopeptide antibiotic with activity against Gram-positive bacteria, including methicillin-resistant organisms. Teicoplanin is administered once daily, either intravenously or intramuscularly. Teicoplanin was given once daily, intravenously or intramuscularly, in the treatment of hospitalized or ambulatory patients with Gram-positive bone or joint infections. A total of 90/98 patients were evaluated for efficacy; 41 had acute osteomyelitis, 41 had chronic osteomyelitis, and 8 had septic arthritis. At the end of therapy, 37 acute osteomyelitis patients were cured/improved with a 90% cure rate at 6-month follow-up; 2 relapsed and 1 failed. At the end of therapy 30 chronic osteomyelitis patients were cured/improved with an 88% cure rate at 6-month follow-up; 2 relapsed and 1 failed. 100% of the septic arthritis patients were cured at the end of therapy and at 1-month follow-up. The most common bacterial isolates cultured from bone were S. aureus (39 isolates), S. epidermidis (11 isolates), other coagulase-negative staphylococci (20 isolates), enterococci (6 isolates), and other streptococcal species (20 isolates). The most common bacterial isolates cultured from joint fluid were S. aureus (6 isolates) and S. epidermidis (2 isolates). All patients tolerated the intramuscular or intravenous routes of administration well. Adverse reactions were mild and most cases did not require discontinuation of therapy. The majority of therapy was administered on an outpatient basis. Teicoplanin was safe, effective, convenient and relatively well tolerated in patients with acute or chronic osteomyelitis or septic arthritis.

Acute Disease↗
PubMed1989

Use of ciprofloxacin in podiatric medicine.

Ciprofloxacin is the first of the new class of antibiotics known as fluoroquinolones to be approved for use in skin, skin structure, and bone and joint infections. It has an extremely broad spectrum and is particularly effective against traditionally resistant gram-negative rods. As an oral agent, it is as effective as parenteral drugs against a variety of organisms and diseases. Its spectrum, pharmacokinetics, and podiatric indications are reviewed.

Bacterial Infections↗
PubMed1988

A multicenter comparative study of cefotetan once daily and cefoxitin thrice daily for the treatment of infections of the skin and superficial soft tissue.

To compare the effectiveness of cefotetan administered at 2 g once a day with cefoxitin at 1 or 2 g three times a day in the treatment of hospitalized patients with skin and superficial soft tissue infections, 194 patients from eight centers were enrolled in an open, randomized trial. Most of the 104 evaluable patients in the cefotetan group and 50 in the cefoxitin group were young men with community-acquired, moderate or severe cellulitis, or abscesses of the upper and lower extremities caused by Staphylococcus aureus, Streptococcus species, Escherichia coli, Proteus mirabilis, Bacteroides fragilis and other species of bacteroides, peptococcus species, and peptostreptococcus species. The mean duration of treatment was 7.5 days for cefotetan and 7.1 days for cefoxitin. A successful clinical response was achieved in 97 percent of the cefotetan patients and in 94 percent of the cefoxitin patients. Of the 88 and 39 bacteriologically evaluable patients in the cefotetan and cefoxitin groups, respectively, a satisfactory bacteriologic response occurred in 96 percent and 87 percent of the patients. No clinically significant changes in clinical laboratory determinations were noted. The incidence of adverse reactions in the cefotetan group (17 percent) was significantly different from that for the cefoxitin group (6 percent) (p less than 0.05); however, the incidence of treatment-related reactions was not significant and the events were mild. Discontinuation of therapy was necessary only in two patients in whom allergic-type reactions developed. A once-daily regimen of cefotetan was as effective as thrice-daily cefoxitin in this study in the treatment of primarily polymicrobial, moderate, or severe infections of the skin and superficial soft tissue.

Abscess↗
PubMed1988

Results of noncomparative studies of cefotetan in the treatment of obstetric and gynecologic infections.

In a multicenter trial involving 11 centers, 160 women were enrolled to evaluate the safety and effectiveness of 1 or 2 gm of cefotetan administered every 12 hours in the treatment of obstetric and gynecologic infections. The 133 evaluable patients generally were under 25 years of age, were nonwhite, and had hospital-acquired endometritis or pelvic inflammatory disease caused by both aerobic and anaerobic bacteria. Escherichia coli, Neisseria gonorrhoeae, group D streptococci, Bacteroides sp., and Peptococcus sp. were among the most frequently isolated pathogens. The patients were treated for a mean of 5.6 +/- 1.6 days and received a total dose of 19.27 gm. The signs and symptoms of infection were cleared or improved in 93% of the 133 patients evaluable for clinical response. Of the 116 evaluated bacteriologically, 95% had a satisfactory or presumed satisfactory response; only six patients (5%) were considered to be bacteriologic failures. Differences in the results of several clinical laboratory tests performed before and after treatment were statistically, but not clinically, significant (p less than 0.05). Safety was evaluated in the 158 patients who received cefotetan, and only four (3%) had adverse reactions considered related to the drug. Cefotetan was clearly effective and produced no untoward reactions in these women with obstetric and gynecologic infections caused by both aerobic and anaerobic organisms when administered at 1 or 2 gm every 12 hours.

Adult↗
PubMed1987

Efficacy and safety of aztreonam in the treatment of serious gram-negative bacterial infections.

Aztreonam was used in the initial treatment of infection of the urinary tract (23 cases), respiratory tract (17 cases), skin and soft tissue (12 cases), abdominal cavity (three cases), endocarditis (two cases), septicemia (eight cases), and osteomyelitis (two cases). In 26 of 60 evaluable infectious episodes, aztreonam was used alone. Clinical cure was observed in 35 of 60, improvement in 24 of 60, and failure in one of 60 cases. Ten patients developed subsequent superinfection. Aztreonam was well tolerated, although one case of exfoliative dermatitis and one of pseudomembranous colitis occurred. However, these cases were complicated by proximal administration of other antibiotics.

Adult↗
PubMed1986

Comparative in vitro antimicrobial activity of carumonam, a new monocyclic beta-lactam.

The antimicrobial activity of carumonam (formerly RO-17-2301), a monocyclic beta-lactam antibiotic, was compared with those of aztreonam, cefotaxime, cefoperazone, ceftazidime, piperacillin, and gentamicin against 455 bacterial isolates. Carumonam did not possess activity against gram-positive cocci and was generally comparable to aztreonam and ceftazidime for most gram-negative bacilli. However, carumonam was the most active beta-lactam against gentamicin-resistant Pseudomonas aeruginosa strains (90% MIC, 8 micrograms/ml).

Anti-Bacterial Agents↗
PubMed1986

In vitro activity of A-56619 and A56620, two new aryl-fluoroquinolone antimicrobial agents.

The in vitro antimicrobial activity of two new aryl-fluoroquinolone antibiotics, A-56619 and A-56620, was compared with those of norfloxacin and several other antibiotics against 448 bacterial isolates. A-56620 was the most active agent tested. The usual 90% MIC of A-56620 was less than or equal to 2 micrograms/ml, except for enterococci, gentamicin-resistant Serratia marcescens, and gentamicin-resistant Pseudomonas aeruginosa, for which the 90% MIC was 4 micrograms/ml. A-56619 and norfloxacin were generally severalfold less active than A-56620. Cross resistance was observed between the quinolone antibiotics and other unrelated antibiotic classes.

Anti-Bacterial Agents↗
PubMed1986

Cefotetan pharmacokinetics in volunteers with various degrees of renal function.

Twenty-six volunteers with various degrees of renal function were given a single 1-g dose of cefotetan intravenously over 30 min. Concentrations of cefotetan and cefotetan tautomer in plasma and urine were determined by high-performance liquid chromatography. The pharmacokinetic parameters for cefotetan were calculated according to a two-compartment open model. The mean plasma cefotetan concentration at the end of the intravenous infusion did not vary with renal function and ranged between 122 and 126 micrograms/ml. The mean terminal half-life was 4.2 h in normal volunteers and 9.9 h in volunteers with moderate renal impairment. There was a significant linear correlation between the systemic clearance of cefotetan and creatinine clearance. The cumulative amount of cefotetan excreted in the urine over 24 h in normal volunteers was approximately 49% of the dose, but this was reduced in volunteers with moderate renal impairment. The mean urinary cefotetan concentrations generally peaked during the 2- to 4-h interval after dosing. Cefotetan tautomer was sporadically detected in the plasma and urine of approximately 50% of the volunteers. The mean plasma cefotetan tautomer concentrations and mean total cumulative urinary recoveries of cefotetan tautomer were only minimal compared with those for cefotetan. The mean percentage of the dose excreted in the urine as cefotetan tautomer was not significantly affected by the degree of renal impairment. Recommendations for the dosing of cefotetan in renal-impaired patients are given.

Adolescent↗
PubMed1985

The participation of activated peritoneal macrophages in Treponema pallidum subspecies pertenue infection in Syrian hamsters.

The role of cell-mediated immunity in hamsters during treponemal infection appears to involve the activated macrophage. To date, studies have been hindered by the inability to confirm that macrophages exhibit enhanced treponemicidal activity at the infection site. We show that lipopolysaccharide and thioglycollate-treated animals, when inoculated with Treponema pallidum subsp. pertenue, exhibit enhanced clearance of these organisms compared with controls. Macrophages from these infected groups display an enhanced respiratory burst, as detected by NBT reduction, as well as a marked increase in C3b receptor-mediated ingestion activity. Significant changes in these parameters indicate that alterations in macrophage activation are occurring in the infected compartment. Thus the stimulatory agents apparently modify the host's immune responses to promote subsequent reduction of treponemal infection. In addition, hamster peritoneal macrophages demonstrate enhanced activation behavior as a result of exposure to at least two signals, which may be prerequisite for processing this organism efficiently.

Animals↗
PubMed1985

Gram-negative bacillary meningitis.

The incidence of gram-negative bacillary meningitis has increased significantly in the past two decades. Approximately two thirds of all reported cases have occurred after neurosurgical procedures. With the development of the newer cephalosporins, the overall mortality rate has decreased from 40 to 80 per cent to 10 to 20 per cent.

Aminoglycosides↗
PubMed1985

Tuberculous meningitis.

Tuberculous meningitis arises from the discharge of bacilli from a subjacent caseous focus into the subarachnoid space. Meningeal involvement is most marked at the base of the brain. The clinical spectrum is very broad and the outcome of therapy depends mainly on the stage of disease at the time treatment is instituted.

Adrenal Cortex Hormones↗
PubMed1985

Comparative in vitro evaluation of cefpimizole (U-63196E), a new antipseudomonal cephalosporin.

The activity of cefpimizole (formerly U-63196E) was compared with that of other broad-spectrum cephalosporins and penicillins. Overall, cefpimizole exhibited limited activity against gram-positive cocci and members of the family Enterobacteriaceae as compared with the other cephalosporins tested. The activity of cefpimizole against Pseudomonas aeruginosa was similar to that of cefoperazone and mezlocillin (90% MIC, 32 micrograms/ml) but poorer than that of ceftazidime (90% MIC, 8 micrograms/ml). Cefpimizole appears to have no in vitro advantage over the cephalosporins with which it was compared.

Cephalosporins↗
PubMed1985

The activity of ceftazidime compared with those of aztreonam, newer cephalosporins and Sch 29482 against nonfermentative gram-negative bacilli.

The activity of ceftazidime was compared with those of aztreonam, newer cephalosporins and Sch 29482 against nonfermentative gram-negative bacilli. Ceftazidime was consistently more active (MIC less than or equal to 8 micrograms) against the nonfermenters. Only Flavobacterium odoratum, F. spp., Pseudomonas alcaligenes, P. maltophilia and P. stutzeri demonstrated substantial resistance (MIC90 greater than or equal to 64 micrograms) to ceftazidime. Sch 29482 and ceftriaxone also exhibited good activity (MIC90 less than or equal to 8 micrograms) against many of the nonfermenters. The broad activity of ceftazidime, however, makes it a potentially more useful therapeutic agent against these microorganisms.

Anti-Bacterial Agents↗
PubMed1985

A comparative study of gentamicin and netilmicin in the treatment of gram-negative infections.

Netilmicin is active in vitro against a wide variety of gram-negative bacteria, including certain gentamicin-resistant isolates, and Staphylococcus aureus. This study presents the results of a prospective, randomized, double-blinded protocol designed to determine the relative efficacy and toxicity of netilmicin and gentamicin in the therapy of gram-negative infections. The demographic make-up of both treatment groups was similar. Cure rates were 96.7 percent with netilmicin and 94.4 percent with gentamicin. Possible transient nephrotoxicity developed in nine patients receiving netilmicin and in eight patients receiving gentamicin.

Adult↗