New developments in antimicrobial therapy.
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Amikacin↗
Biomedical subjects
M F Parry
Publications and source records attributed to M F Parry.
Acute interstitial nephritis associated with carbenicillin therapy.
Although acute interstitial nephritis has been documented during therapy with many antibiotics of the penicillin class, it has not previously been reported in association with carbenicillin therapy. We report here the case of a patient who developed the characteristic clinical features of this form of injury while receiving prolonged large doses of carbenicillin. Histologic examination confirmed the presence of a striking interstitial nephritis. Carbenicillin should be considered a potential cause of renal damage in patients who develop rash, eosinophilia, and microscopic hematuria in association with deterioration of renal function.
Acute Disease↗
Babesia microti infection in man.
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Animals↗
Treatment of pulmonary infections in patients with cystic fibrosis: a comparative study of ticarcillin and gentamicin.
The effectiveness of ticarcillin against Pseudomonas aeruginosa in acute exacerbations of pulmonary infection in patients with cystic fibrosis was evaluated. Seventy-one percent of patients treated with ticarcillin alone responded favorably. The response rate was similar in patients treated with a combination of ticarcillin plus gentamicin or with gentamicin alone. Severity of the underlying disease was the most important determinant of response to treatment. Ticarcillin-resistant organisms were recovered during treatment in 50% of patients who received this drug; recovery of them was not prevented by the inclusion of gentamicin in the therapeutic regimen nor did they interfere with clinical improvement. The ticarcillin-resistant strains persisted at follow-up, two to six months after completion of therapy, in only one of ten patients. No serious toxicity to ticarcillin was noted during the study period.
Adolescent↗
Effect of N-acetylcysteine on antibiotic activity and bacterial growth in vitro.
The antibiotic bacerial inactivity of N-acetylcysteine (NAC) and its interaction with penicillin and aminocyclitol antibiotics was evaluated. NAC inhibited growth of both gram-negative and gram-positive bacteria. Strains of Pseudomonas aeruginosa were more susceptible than other microorgainsms tested. P. aeruginosa strains were inhibited synergistically by NAC and carbenicillin or ticarcillin. However, NAC antagonized the activity of gentamicin and tobramycin. These findings have implications for the combined clinical use of NAC and aerosolized antibiotics and are also important for the processing of sputum specimens in the microbiology laboratory.
Acetylcysteine↗
Pharmacokinetics of ticarcillin in patients with abnormal renal function.
The pharmacokinetics of ticarcillin were determined in patients with abnormal renal function. In individuals with rates of creatinine clearance of greater than 60 ml per min, the half-life (+/- standard deviation) of ticarcillin was 71 +/- 6 min after intravenous administration. In patients with rates of creatinine clearance of 30-60 ml per min, 10-30 ml per min, and less than 10 ml per min, ticarcillin had a half-life of 3.0 +/- 0.6 hr, 8.5 +/- 2.1 hr, and 14.8 +/- 3.7 hr, respectively. Urinary concentrations of ticarcillin after intravenous administration were adequate at all levels of renal function. Ticarcillin was removed by hemodialysis with a reduction in half-life to 3.4 +/- 0.8 hr, but peritoneal dialysis was minimally effective in removing the drug. A program for the use of ticarcillin patients with renal insufficiency was outlined.
Clinical Trials as Topic↗
Tobramycin and ticarcillin therapy for exacerbations of pulmonary disease in patients with cystic fibrosis.
Patients who had cystic fibrosis and acute infectious exacerbations of pulmonary disease produced by Pseudomonas aeruginosa were treated with a combination of tobramycin and ticarcillin. P. aeruginosa recovered from patients was inhibited by lower concentrations of both of these drugs than of gentamicin or carbenicillin. Thirteen courses of treatment were administered to 11 patients (mean, 14.4 days). A favorable response was seen in 11 of 12 completed courses of treatment. Improvement was associated with decreases in white blood cell count, temperature, and sedimentation rate. Adverse reactions were uncommon. Although P. aeruginosa was not eradicated from the sputum, the clinical results suggest that the combination of tobramycin and ticarcillin may be particularly useful for treatment of acute exacerbations of pulmonary disease in patients with cystic fibrosis from whom P. aeruginosa is isolated.
Adolescent↗
Pharmacokinetics of cefamandole in the presence of renal failure in patients undergoing hemodialysis.
The pharmacology of cefamandole in seven patients with stable renal insufficiency and in eight patients undergoing hemodialysis was determined. All patients had creatinine clearances less than 5 ml/min. The half-life of cefamandole in those patients with stable chronic renal failure was 7.7 +/- 2.2 h. The mean venous level 1 h after intravenous injection of a 1-g dose was 85.3 +/- 32.0 mug/ml. The mean venous half-life of cefamandole during hemodialysis was 6.1 h. The venous serum level after 5.5 of hemodialysis was 50.4 +/- 20.8 mug/ml. The mean coefficient of extraction was 0.155, and the mean clearance was 34.7 ml/min. The time interval between doses of cefamandole administered intravenously should be lengthened to 24 h in the presence of stable renal failure. No major change in dosage schedule is necessary for patients undergoing dialysis.
Adult↗
Comparison and evaluation of ticarcillin and carbenicillin using disk diffusion methods.
Ticarcillin has proved to be two- to fourfold more active than carbenicillin against most strains of Pseudomonas aeruginosa. Although susceptibility of the Enterobacteriaceae to ticarcillin could be predicted from results obtained with carbenicillin disks, neither the 50-mug nor the 100-mug carbenicillin disk proved suitable for testing susceptibility of P. aeruginosa to ticarcillin. Forty-three percent of Pseudomonas strains judged to be resistant to carbenicillin by the 100-mug carbenicillin disk were susceptible to ticarcillin by agar dilution studies. Results obtained with a 75-mug ticarcillin disk showed excellent correlation between zone size and ticarcillin minimal inhibitory concentration values and produced good discrimination between resistant and susceptible strains of Pseudomonas as determined by agar dilution studies. Using a 75-mug ticarcillin disk, a zone size of 12 to 14 mm was appropriate for designating intermediate susceptibility, and a zone greater than or equal to 15 mm was appropriate for designating susceptible strains of both P. aeruginosa and the Enterobacteriaceae.
Carbenicillin↗