[Bacterial meningitis. A 5-year's material from Göteborg and Uddevalla].
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Biomedical subjects
Publications and source records attributed to K Alestig.
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After single oral or intravenous doses of doxycycline the concentrations found in the spinal fluid did not exceed 0.1 mcg/ml. Daily oral administration for 2-10 days gave a level in the spinal fluid of 0.1-0.76 mcg/ml. The mean value, 0.37 mcg/ml, corresponded to 14% of the concentrations found in serum. Further studies of the penetration of doxycycline in patients with a damaged blood-brain barrier should be performed before doxycycline can be recommended for the treatment of CNS-infections.
The excretion of doxycycline was studied in patients with ileostomies after intravenous administration of the drug. The intestinal excretion, measured by bioassay, was of the same magnitude as reported in normal human beings when similar methods have been used. If the main part of a dose of doxycycline is secreted and bound in the intestine, this study suggests that the large bowel is not important for this binding.
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The effect on the aerobic faecal flora of a 10-day course of doxycycline or tetracycline hydrochloride was compared in 36 patients with acute infections mainly of respiratory origin. The patients were treated in hospital with a well-developed barrier nursing technique. The proportions of isolates of Escherichia coli resistant to tetracyclines were significantly lower after 10 days' treatment with doxycycline (80%) as well as one month later (24%), compared to the figures for tetracycline HCI (100% and 46%, respectively). The resistant strains selected during therapy probably represented the community flora. Only a small increase in multiresistant strains occurred and no identical strains were found in different patients. Thus, it seems possible to limit the biological side-effects of tetracyclines by a good barrier nursing technique. An increase in the number of E. coli resistant to tetracyclines cannot be avoided, but is more limited when doxycycline is used.
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