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Biomedical subjects

J M Hamilton-Miller

Publications and source records attributed to J M Hamilton-Miller.

At least 181 records · Page 10Linked to original sources
PubMed1983

Long-term prophylaxis of urinary infections in women: comparative trial of trimethoprim, methenamine hippurate and topical povidone-iodine.

We randomized 64 patients with a history of recurrent urinary tract infections among 3 regimens of long-term (1 year) prophylactic treatment: 20 were given 100 mg. trimethoprim at night, 25 received 1,000 mg. methenamine hippurate every 12 hours and 19 were asked to cleanse the perineum (especially the periurethral area) twice daily with povidone-iodine solution. The progress of patients in terms of urinary symptoms and/or bacteriuria, changes in periurethral flora, side effects, and hematological and biochemical profiles was followed at regular intervals. All treatments were effective in reducing the incidence of symptomatic attacks when compared to the 12 months immediately before therapy and there was little to choose between the individual regimens on this account. However, trimethoprim was tolerated better than were the other 2 treatment regimens. In the group given trimethoprim most of the breakthrough infections (71.4 per cent) that occurred were caused by trimethoprim-resistant organisms (usually Escherichia coli), while in the other 2 groups the incidence of trimethoprim-resistant organisms causing infection was low (2.7 per cent). Treatment with trimethoprim reduced significantly the periurethral colonization of Escherichia coli.

Administration, Topical↗
PubMed1983

Evidence for a slowing in trimethoprim resistance during 1981--a comparison with earlier years.

Two thousand seven hundred bacterial strains, isolated during 1981 from urine specimens both from patients in hospital and general practice, were examined for resistance to trimethoprim. The incidence of such resistance was 13% in the hospital isolates and 5.8% in the general practice strains. High level resistance (MIC greater than 1 mg/ml) was present in 75-90% of the resistant strains. With the exception of Staphylococcus epidermidis and Proteus mirabilis, almost all the trimethoprim-resistant strains were also resistant to sulphonamide. In 410 strains from sputum specimens the incidence of resistance was 5.4%. Disc testing for the determination of sensitivity of urine isolates is best carried out using a 5 micrograms disc, while for sputum isolates our present experience indicates that a 1.25 micrograms disc is most appropriate. Our results indicate that the rate of increase in the acquisition of resistance to trimethoprim appears to have slowed down compared with the period 1975-1977, and that almost all this resistance is now high level. The introduction of trimethoprim alone for therapeutic use appears to have little if any effect on the incidence of trimethoprim resistance.

Bacteria↗
PubMed1983

The biliary excretion and pharmacokinetics of mezlocillin in jaundiced patients with external bile drainage.

The biliary excretion and pharmacokinetics of mezlocillin have been studied in jaundiced patients with total external bile drainage through a percutaneous transhepatic catheter. In 10 of 11 studies, 2 g mezlocillin intravenously resulted in biliary concentrations sufficient to exceed the minimum inhibitory concentrations of most common biliary pathogenic organisms. In 6 h, 0.2-6.2% of the dose given was recovered in bile. The biliary clearance was 0.21-7.82 ml/min and increased with the duration of biliary decompression. The serum half-life of mezlocillin was prolonged (1.81 +/- 0.23 h, mean +/- SD), and was due to reduced biliary and renal clearance.

Adolescent↗
PubMed1983

Phenomenon of resistance to Augmentin associated with sensitivity to ampicillin: occurrence and explanation.

Ampicillin was found to be some tenfold more active than amoxycillin against Enterobacter cloacae. This finding explains the observation that some Ent cloacae strains are sensitive to ampicillin in the disc test but resistant to Augmentin. Ampicillin was also found to be more active than amoxycillin against Citrobacter freundii and Serratia marcescens. In view of these findings, the practice of using ampicillin discs to predict sensitivity to amoxycillin should be reconsidered. The use of both ampicillin and amoxycillin discs is appropriate if errors are to be avoided.

Amoxicillin↗
PubMed1982

Pivmecillinam in complicated urinary infections failing to respond to conventional therapy.

Forty-three patients with a history of recurrent urinary infections, many of whom had renal involvement and had recently failed treatment, were then treated with pivmecillinam (400 mg 8-hourly for seven days). One week after the end of treatment the bacteriological cure rate was 72.1%. During the following four weeks, however, several of the cured patients relapsed, so that the cure rate five weeks after the end of treatment was only 46%. Thus, it is recommended that such patients should begin prophylactic treatment if found to be abacteriuric after the one week follow-up. Pivmecillinam was extremely well tolerated.

Adult↗
PubMed1982

Anaerobic periurethral flora of healthy women and women susceptible to urinary-tract infection.

The anaerobic periurethral microbial flora of 25 healthy women was compared with that of 29 women attending the urinary-tract-infection clinic at the Royal Free Hospital. The latter group consisted of 19 patients receiving long-term prophylactic antimicrobial therapy and 10 with proven recurrent urinary-tract infection not receiving prophylactic treatment. The numbers and species of anaerobes isolated from each group were similar. Lactobacillus spp. were the most frequently isolated organisms in each group and the most numerous. Bacteroides spp. were the next most frequently isolated. In any one subject, the anaerobic flora varied considerably during the study period of approximately 6 months. Thus, the anaerobic flora is not affected by recurrent urinary-tract infection in the past nor by the use of prophylactic chemotherapy. It does not appear to exert a protective role against the initiation of urinary-tract infection.

Adult↗
PubMed1982

A concise biotyping system for differentiating strains of Escherichia coli.

A six test biotyping system comprising fermentation of dulcitol, sorbose, raffinose, and 5 ketogluconate, motility and production of beta-haemolysis was used to obtain biotype profiles for 514 strains of Escherichia coli isolated from the urinary tract. This profile was suffixed to the API-20E code, recorded when the strains were originally identified. An expanded and reliable biotyping system was thus created giving a greater number of possible biotypes than with either system alone. The sensitivity in terms of distinguishing the organisms studied was therefore greatly increased. The use of O-serotyping in combination with biotyping is discussed. Biotyping can also be usefully supplemented by the determination of the eight commonest E coli O-serotypes. This is of value in many clinical situations where differentiation of organisms is vital to the proper analysis of results.

Bacteriological Techniques↗
PubMed1982

Biophotometric comparison of cephalexin and cephradine against gram-positive bacteria.

We have compared the antibacterial activities of cephalexin and cephradine against Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus (Micrococcus spp. type III), and group B streptococci (35 strains in total), using the Biophotometer. Analysis of growth curves obtained in the presence of various concentrations of the antibiotics revealed little difference between the activities of the two cephalosporins. However, both antibiotics showed maximal activity at 8-16 microgram/ml, and increasing the concentration past this point resulted in a reduced antibacterial effect. Unlike the other species tested, streptococci were not lysed by cephalexin or cephradine.

Cephalexin↗