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Biomedical subjects

J M Hamilton-Miller

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

At least 217 records · Page 12Linked to original sources
PubMed1980

The role of periurethral colonization in the aetiology of recurrent urinary infection in women.

Periurethral bacterial colonization was studied in two groups of women by taking samples with a polystyrene sponge. Just over half (56 per cent) of 81 sexually-active women attending a family planning clinic were not colonized in the periurethral area; subjects who were colonized usually showed large numbers of a single bacterial species. On the other hand, all 38 patients who were attending a clinic because of recurrent urinary infections were colonized in the periurethral area; most of these yielded a heavy growth, and more than one bacterial species was usually isolated. Gram-positive cocci predominated as the colonizing flora in both groups, a finding which is in marked contrast to the predominant aetiological agents in urinary infections, namely Gram-negative bacilli. We therefore conclude that colonization of the periurethral area is not the decisive event in the initiation of a urinary infection.

Adolescent↗
PubMed1980

Evidence that rifampicin can be used safely for non-tuberculous diseases.

The incidence of primary resistance to rifampicin in Mycobacterium tuberculosis has been analysed in countries where rifampicin is restricted to use for treating tuberculosis and in countries where its use is not restricted. There is no evidence that rifampicin-resistant M tuberculosis strains are more common where the use of the drug is unrestricted. Resistance to rifampicin is less common than is resistance to streptomycin or to isoniazid. We can thus see no danger of producing resistant strains of M tuberculosis if rifampicin therapy is used for short periods for non-tuberculosis infections. The problem of resistance mutants arising in the non-tuberculous species being treated is overcome by combining rifampicin with trimethoprim.

Drug Resistance, Microbial↗
PubMed1980

Sputum and blood concentrations of cefuroxime in lower respiratory tract infection.

A detailed pharmacokinetic study of cefuroxime has been carried out. Levels of cefuroxime were determined in the blood, sputum, saliva, and urine of 23 patients receiving parenteral cefuroxime eight hourly for chest infections. Profiles were obtained after the first dose and on the final (fifth) day of treatment. Antibiotic levels in the sputum reached 0.8 mg/l within one hour of the first injection, and were maintained close to this value for six hours. There was a build-up by the fifth day, mean cefuroxime concentrations at this time reaching 1.8 mg/l. This concentration was maintained for a prolonged period. Salivary concentrations were detectable but low (maximum mean value was 0.6 mg/l). Concentrations of antibiotic were significantly higher in the serum than those observed after the same doses in volunteers. In the patients there was no build-up in serum levels between the first and fifth days. The data obtained explain the clinical efficacy of cefuroxime in the treatment of lower respiratory infections, and suggest that a 12-hour schedule may be feasible.

Bronchitis↗
PubMed1980

Clinical study of cefuroxime in the treatment of lower respiratory tract infections.

Twenty-three hospital in-patients with severe lower respiratory tract infections were treated with cefuroxime sodium. The drug was given intramuscularly in a dose of either 750 mg or 1000 mg at 8-hourly intervals for 5 days. Of the 21 patients who could be assessed, the response to treatment was highly satisfactory and there were no treatment failures. Eight patients had failed to respond to a course of oral antibiotics before being seen. Most of the patients were elderly and all were very ill. The sputum became mucoid in all but 1 patient. There was no change in tests of liver or renal function. Cefuroxime appears to be an effective and well-tolerated drug for the treatment of patients with severe chest infections.

Adult↗
PubMed1980

Trimethoprim.

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Anti-Infective Agents, Urinary↗
PubMed1980

The effect of acetohydroxamic acid on the induction of bacterial ureases.

The ureases of Proteus mirabilis, Proteus vulgaris, and Proteus rettgeri are inducible by urea. Induction is increased when both urea and acetohydroxamic acid, an inhibitor of urease, are present during bacterial growth. Acetohydroxamic acid alone does not cause induction, but, by preventing the hydrolysis of urea, it minimizes pH increases and allows induction to occur much more effectively. The ureases of Proteus morganii and other bacterial genera are not inducible by this method. The relevance of our findings to the formation and management of infection stones is discussed.

Enzyme Induction↗
PubMed1979

Biliary excretion of erythromycin after parenteral administration.

1 The biliary excretion of erythromycin has been studied following parenteral administration in 23 patients. 2 Mean bile levels of the drug were approximately ten times higher than corresponding serum concentrations 1 h after i.v. (erythromycin lactobionate) and i.m. (erythromycin ethylsuccinate) injection. 3 Thus, unlike many antimicrobial agents, these compounds are well concentrated in the bile.

Bile↗
PubMed1979

Incidence and mechanisms of resistance to trimethoprim in clinically isolated gram-negative bacteria.

Over an 18-month period (October 1973 to April 1975), 133 strains of gram-negative bacteria with acquired resistance to trimethoprim (TM) were isolated from infected urines cultured at the Royal Free Hospital. The overall frequency of resistance was 3.2%. A disproportionately high number of resistant strains (63.1%) were Kebsiella aerogenes. Resistance to TM mediated by R plasmids occurs infrequently (9% of all resistant strains); the majority of TMR plasmids isolated belonged to one incompatability group (W). Chromosomally mediated resistance to TM in most Escherichia coli and K. aerogenes strains appears to be due mainly to production of a dihydrofolate reductase with a reduced susceptibility to TM. In some strains, increased activity of the DHFR was also a contributing factor. Increase in enzyme level alone was only great enough to account for the level of resistance to TM in a small number of cases.

Bacteria↗
PubMed1979

Combined action of sulphamethoxazole and trimethoprim against clinically-isolated sulphonamide-resistant bacteria.

42 strains of gram-negative bacteria, isolated from clinical material, resistant to trimethoprim (TM), sulphamethoxazole (SMZ) or both, have been tested for synergistic sensitivity to TM + SMZ. The combination showed no synergy against strains 'highly resistant' to SMZ (MIC greater than 1 mg/ml). Indifference was invariably observed. However, synergy was seen with strains 'moderately resistant' to SMZ (MIC 100--1,000 microgram/ml). Our results indicate that present techniques for the testing of urinary tract isolates for sensitivity to co-trimoxazole need revision.

Acinetobacter↗
PubMed1979

Rapid screening for urease inhibitors.

Two methods are described that are suitable for the rapid screening of compounds as urease inhibitors. The first utilizes an electrode sensitive to NH4+ ions; the second is dependent on pH rise. A feature of both is a direct readout of reaction rate.

Acetazolamide↗