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Biomedical subjects

M I Marks

Publications and source records attributed to M I Marks.

223 records · Page 13Linked to original sources
PubMedDate not supplied

Microbiology of recently treated acute otitis media compared with previously untreated acute otitis media.

Isolates were obtained from 169 middle ear aspirates of 148 children with recently treated acute otitis media (RTOM) and from 123 aspirates of 84 children with previously untreated acute otitis media (UOM). In RTOM Streptococcus pneumoniae and Group A streptococcus (P less than 0.02) were recovered less frequently whereas Staphylococcus aureus (P less than 0.001) and Haemophilus influenzae (P less than 0.02) were recovered more frequently than in UOM. Patients with RTOM had more beta-lactamase-producing organisms and multiple isolates. Bilateral sterile aspirates were more common in RTOM although bilateral otitis media was more common in UOM. In RTOM most Branhamella catarrhalis isolates were co-pathogens whereas Staphylococcus epidermidis were always isolated in pure culture. Amoxicillin was the antimicrobial most frequently (83.9%) received for the recently treated episode of otitis media. In RTOM 62.4% of isolates were susceptible to previously prescribed antibiotics, suggesting that factors other than antimicrobial susceptibility are also important in the occurrence of RTOM.

Acute Disease↗
PubMedDate not supplied

Chloramphenicol: recent developments and clinical indications.

Recent developments (including more accurate assays) that have led to revised recommendations for route of administration, dosage, and indications for chloramphenicol are reviewed. Chloramphenicol is most bioavailable by the oral route; doses of 75 mg/kg/day provide adequate therapeutic concentrations for most clinical indications. Serum concentrations of the drug should be monitored to ensure adequate therapeutic concentrations and to avoid toxicity. This is particularly important in newborns, in patients with liver dysfunction, and in those receiving concomitant drugs that may influence free chloramphenicol concentrations. The indications for chloramphenicol therapy evaluated are: Haemophilus influenzae infections, anaerobic infections, salmonellosis, Rocky Mountain spotted fever, and eye infections. Chloramphenicol is useful in the treatment of invasive Haemophilus influenzae infections resistant to ampicillin, in selected anaerobic and ocular infections, and for rickettsioses in patients under the age of eight years. Because the rare but life-threatening complication of chloramphenicol (aplastic anemia) persists, indications for the drug's clinical use are narrowing once again with the advent of third-generation cephalosporins highly active against gram-negative bacilli including ampicillin-resistant H. influenzae. Similarly, metronidazole or clindamycin may be preferred for some anaerobic infections.

Bacteroides Infections↗
PubMedDate not supplied

Chloramphenicol: properties and clinical use.

Chloramphenicol was introduced into medical practice in 1949. At therapeutic concentrations of 10 to 20 micrograms drug per ml, the drug inhibits bacterial ribosomal and, to a lesser extent, mammalian mitochondrial protein synthesis but concentrations above 60 micrograms drug per ml induce progressive reduction of oxygen-dependent cellular metabolism. Some adverse reactions (e.g. bone marrow suppression and the "gray baby syndrome") reflect these effects. The pathogenesis of chloramphenicol-induced aplastic anemia remains unclear. Chloramphenicol is most bioavailable after oral administration and has a remarkable ability to diffuse into body fluids and tissues. However, there are wide interindividual variations in its metabolism and elimination, particularly in newborns. Chloramphenicol is indicated for invasive ampicillin-resistant H. influenzae infections; for patients allergic to penicillin with pneumococcal, meningococcal or H. influenzae meningitis; in patients under 8 years of age with Rocky Mountain spotted fever; and for the treatment of brain abscess and other severe anaerobic infections (excluding endocarditis) due to B. fragilis. Other indications include selected patients with Salmonella meningitis or carditis, rickettsioses and intraocular infections. Unravelling the pathogenesis of chloramphenicol-induced aplastic anemia is critical to more widespread application of this remarkable antimicrobial.

Bacteroides Infections↗