Evaluation of cefoperazone in the therapy or urinary tract infections.
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Biomedical subjects
Publications and source records attributed to J S Tan.
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An inclusion body encephalitis developed in a patient with a renal transplant that was shown by immunofluorescence and electron microscopic studies to be due to measles virus. Measles encephalitis may be an opportunistic infection in children and adults with immunodeficiencies secondary to tumors or to the administration of immunosuppressive drugs.
Janeway lesions in three patients with infective endocarditis caused by Staphylococcus aureus were biopsied. Two taken before therapy, showed evidence of suppuration and microabscesses. The other lesion which developed while the patient was on appropriate therapy, showed minimal inflammatory reaction.
The diffusibility of bacampicillin, ampicillin, cephalothin, and cephapirin into human interstitial fluid was investigated by using crossover studies. We compared bacampicillin with ampicillin and found that bacampicillin was better absorbed after oral administration. Blood, interstitial fluid, and urine levels were consistently higher in volunteers who received bacampicillin. We compared cephalothin with cephapirin and found that blood and interstitial fluid levels were comparable throughout the study.
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The ability of eight antibiotics (carbenicillin, ticarcillin, cefamandole, cephalothin, cefazolin, gentamicin, tobramycin, and amikacin) to enter human interstitial fluid was evaluated by the skin window technique. All of the antibiotics tested, except cefazolin, which has the highest percentage of protein binding, diffused into the interstitial fluid quite well. This study confirms our previous observation on the effect of high-percentage protein binding on diffusion of a drug into the minimally inflamed extravascular space.
The available literature on the nitroblue tetrazolium reduction test is reviewed. The mechanism of this test is poorly understood. There are two basic methods of performing the test, namely, the stimulated and the spontaneous methods. However, the test procedure has not been standardized, and numerous modifications have ensued resulting in a number of technics. The stimulated test has proved to be valuable for screening patients or carriers with chronic granulomatous disease of childhood. It is one of the useful tests in studying neutrophil dysfunction. On the other hand, extensive accumulated data indicate that this test, be it stimulted or spontaneous, cannot be relied upon as an absolute test to differentiate bacterial from nonbacterial infectious disease as there have been numerous false-positive and false-negative results. When this test is used, the result should be interpreted in the context of other laboratory test results and the clinical picture of the patient. Preliminary data indicate that in certain diseases, if the initial test is positive in a particular patient, it may be useful as one of the follow-up tests to ascertain the activity of the disease process.
Strains of Pseudomonas aeruginosa, with resistance to gentamicin and carbenicillin which is R factor mediated, showed no alteration in virulence as tested by intraperitoneal injection of rats.
The authors measured levels of clindamycin, a drug well established as useful in the treatment of various soft-tissue and parenchymal bacterial infections, in serum, cerebrospinal fluid, and brain tissue of 14 rhesus monkeys. Penetration into brain tissue was erratic and concentrations detected were not significant. Cerebrospinal fluid levels, however, averaged 20.5% of paired serum concentrations and were higher than concentrations needed to inhibit most Gram-positive bacteria. Further studies in humans are indicated before this antibiotic may be used routinely.
The neutrophil bactericidal capacity of 31 patients with diabetes mellitus in a nonketoacidotic state, including 21 without infections and 10 with recurrent infections, were evaluated. The killed intracellular bacteria (KICB) expressed as the percentage of the initial inoculum for 25 normal control subjects was 95.4 (SD equal plus and minus (2.7) and that for the diabetic patients, the KICB was 72.8 (SD=+30.7)with a p value of less than or equal to 0.01. In 17 out of 31 diabetic atients, the KICB was greater than minus two standard deviations of the control mean. Using the lysostaphin assay technic, 11 patients were shown to phagocytize poorly, 3 had impaired intracellular killing and 3 had a combined defect. These defects were not correctable by normal serum nor related to blood-glucose levels. No apparent correlation with infection could be demonstrated. Fiver of the 10 patients with recurrent infections and 12 out ot of 21 patients without infections has a neutrophil dysfunction. However, all 3 patients with a combined defect had severe bacterial infections.
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