Search PubMed⌕ Search

Biomedical subjects

L Riff

Publications and source records attributed to L Riff.

9 recordsLinked to original sources
PubMed1988

P & T Committee interview: strategies to ensure an effective formulary system.

In this exclusive Hospital Formulary interview, Louise Riff, MD, and Richard Hutchinson, PharmD, highlight the challenges of their 15-year tenure as the Chairman and Secretary of the University of Illinois Hospital P & T Committee. While continuity in formal leadership has been advantageous, they also attribute part of their success to the diverse informal leadership that develops each year. Drs. Riff and Hutchinson discuss how the P & T Committee has become accomplished at making what once were controversial decisions, such as removing the number one drug from their formulary as a cost-containment strategy. They also describe the recent development of an improved ADR reporting system and the progress in exchanging formulary decisions with neighboring hospitals. This P & T Committee, however, expresses some discomfort with the evaluation of high-tech drug products, since significant cost implications without therapeutic guarantees create new dimensions in decision-making for their Committee.

Anti-Bacterial Agents↗
PubMed1983

Chloramphenicol kills Haemophilus influenzae more rapidly than does ampicillin or cefamandole.

The bactericidal effects of chloramphenicol and three beta-lactams (ampicillin, cefamandole, and penicillin G) were measured for 27 strains of Haemophilus influenzae type b isolated from the blood or cerebrospinal fluid of infected infants. Of the ampicillin-susceptible strains, 75% were killed by less than 2.0 micrograms of each antibiotic per ml; however, the concentration of the beta-lactam agents required for bactericidal activity was higher than that required for inhibitory activity. Chloramphenicol was the only agent which had no marked discrepancy between inhibitory and bactericidal concentrations regardless of beta-lactamase production. Importantly, chloramphenicol was more rapidly bactericidal than either ampicillin or cefamandole. The bactericidal requirement of ampicillin was increased by the presence of chloramphenicol for about one-third of the isolates examined. Neither the inhibitory nor the bactericidal activity of chloramphenicol was influenced by ampicillin. Synergy occurred for only two beta-lactamase-positive isolates. The more rapid bactericidal action of chloramphenicol persisted even in the presence of ampicillin. The rapid bactericidal action of chloramphenicol with or without ampicillin supports the use of chloramphenicol alone or with ampicillin for H. influenzae infections.

Ampicillin↗
PubMed1982

Tobramycin and gentamicin are equally safe for neonates: results of a double-blind randomized trial with quantitative assessment of renal function.

The frequent use of aminoglycosides in neonates led us to compare tobramycin and gentamicin because some studies in adults and animals suggested a safety advantage for tobramycin. In a randomized, double-blind comparison, 50 infants < or = 3 days old received either tobramycin or gentamicin, 2.5 mg/kg/12 hr, for a mean of 8 days. The groups were similar for gestational age, birth weight, underlying disease, Apgar score, clinical condition, renal function, and concurrent use of other drugs. Trough and postdose serum concentrations of both drugs were similar in each weight group. Renal status at onset, during or up to 2 wk after therapy was also similar, as judged by urinalysis, serum creatinine, fractional excretion of Na, urine N-acetyl-beta-glucosaminidase, and urine to serum creatinine ratio. Nephrotoxicity occurred in four infants (13%) receiving tobramycin and three infants (15%) receiving gentamicin. No otoxicity, as measured by auditory brainstem response, was noted in either group. Tobramycin offered no safety advantages over gentamicin in neonates, and the choice between the agents should be based on other considerations, such as susceptibility of the pathogen and cost.

Bacterial Infections↗
PubMed1977

Antimicrobial therapy of experimental group B streptococcal infection in mice.

Group B beta-hemolytic streptococci (GB-BHS) frequently cause severe infection in newborns. Previous in vitro studies showed accelerated killing of GB-BHS by ampicillin plus gentamicin as compared with ampicillin alone. To extend the in vitro observations, mice were infected experimentally with GB-BHS and treated with gentamicin plus ampicillin or ampicillin alone. Untreated mice died within 10 to 48 h. Compared with treatment with ampicillin alone, ampicillin-and-gentamicin therapy resulted in improved survival when the antibiotics were given in established infection or as a single dose at the time of infection. Ampicillin and gentamicin accelerated the clearing of bacteremia as compared with treatment with ampicillin alone. In view of these findings, the therapy of GB-BHS infection in newborns and other patients should be reconsidered in that a combination of ampicillin or penicillin G plus gentamicin might be superior to the use of ampicillin or penicillin G alone.

Ampicillin↗
PubMed1976

Antibiotic-killing kinetics of group B streptococci.

Group B streptococci are uniformly susceptible to penicillin or ampicillin. Nevertheless, morbidity and mortality in newborn infants infected with group B streptococci is a major clinical problem. Bacteriologic determinants in the outcome of this infection were studied. Streptococcal killing kinetics were studied for ampicillin alone and in combination with gentamicin. In all cases killing was accelerated by the combination. The practice of discontinuing administration of the aminoglycoside antibiotic when group B streptococcal infection is confirmed should be re-evaluated.

Ampicillin↗