Present day susceptibility of urinary pathogens to antimicrobials.
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Biomedical subjects
Publications and source records attributed to M S Sabbour.
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Sixty-four patients with complicated UTI (58) and P. aeruginosa ear infections (6) were treated with oral ofloxacin. All patients were infected with multiply-resistant problem organisms, which had very low minimum inhibitory concentrations (MICs) when tested in vitro with ofloxacin. The immediate cure rate was 86% and the maintained cure rate was 75%, an excellent result considering the complicated nature of the infections. This result has been attributed to the great efficacy of ofloxacin and its excellent pharmacokinetics. There was a very low incidence of mild side effects. Because resistance to quinolones is not mediated by R-factors, it is recommended to select them as first choice in the treatment of patients with complicated UTI with indwelling catheters or nephrostomy tubes, and in patients with discharging ears in order to limit the spread of resistant strains in the hospital environment and in the community.
The dialyzability of cefotaxime and mecillinam was studied in 20 patients with end-stage renal failure maintained on regular hemodialysis in the Ain Shams Dialysis Unit. Cefotaxime was found to be a dialyzable antibiotic with a hemodialysis clearance rate of 60.3 +/- 10.4 ml/min. Mecillinam was found to be more dialyzable, with a clearance rate of 118.8 +/- 14.4 ml/min.
Ninety-six patients with pathologically-proven, chronic, active hepatitis were studied to evaluate different lines of treatment. Patients were divided into the following groups: control (followed without specific active treatment), corticosteroid group, azathioprine group, corticosteroid and azathioprine group, chlorambucil group, 5-fluorouracil group, colchicine group and isoprinosine group. Patients were followed clinically, biochemically, and histopathologically. Results showed that patients put on any therapeutic regimen did either the same or worse than the control group left without active therapy. There was no difference in response to treatment between HBsAg +ve or -ve patients; both groups showed no improvement. Some patients given active treatment developed the side effects and complications from the drug used.
This work was intended to study the incidence of beta-lactamase producing Escherichia coli isolated from urinary tract infections. Urine samples from 123 patients suffering from manifestations of urinary tract infection were examined bacteriologically according to Cruickshank et al. The isolated E. coli strains were tested for beta-lactamase production by: rapid microtube iodometric test, rapid slide iodometric test and rapid acidimetric test. The incidence of E. coli strains was 65.94% with a high incidence of beta-lactamase production (69.14%).
The aminoglycosides gentamicin, tobramycin, netilmicin and aztreonam were tested for their effects on migration inhibition factor production by mouse lymphocytes challenged by phytohemagglutinin in vitro. The three aminoglycosides were found to depress its production while aztreonam was devoid of this depression effect.
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163 patients with diffuse lupus glomerulonephritis, proven by renal biopsy, were divided into four therapeutic trial groups: 67 were put on corticosteroids alone, 11 on corticosteroids and azathioprine, 32 on corticosteroids and cyclophosphamide, and 53 on corticosteroids and chlorambucil and were followed up for several years. The addition of azathioprine to corticosteroids did not increase the survival rate, improve the renal function or alter the grim prognosis of the patients. Cyclophosphamide appeared to influence favourably the pathological lesion and the renal function when added to corticosteroids, and the disease progressed at a slower rate. The fatal side effects nearly balanced the therapeutic value of cyclophosphamide. Patients on corticosteroids and chlorambucil had an excellent course. This therapeutic regimen resulted in resolution or regression of the renal pathology, marked improvement of the renal function and marked improvement of the survival rate. The authors believe that this therapeutic regimen holds the best chance of becoming the standard treatment for lupus nephritis, particularly since the side effects of chlorambucil were minimal.
The purpose of this study was to determine the effectiveness and tolerability of norfloxacin, cinoxacin and oxolinic acid in the treatment of urinary tract infections (UTI) in comparison to nalidixic acid. 125 patients were given the drugs in the appropriate doses for 10-14 days and 30 patients were treated for six weeks. Clinical, bacteriological, hematological and chemical checks were made on all patients before and after treatment. It was found that norfloxacin, cinoxacin and oxolinic acid are safe and effective against Escherichia coli, Klebsiella and Proteus, the commonly encountered organisms in urinary tract infections. The cure rate for norfloxacin was 93%, for cinoxacin 83%, for oxolinic acid 80% and for nalidixic acid 70% in the short course. However, these differences were not statistically significant. Oxolinic acid, cinoxacin and norfloxacin have the advantage over nalidixic acid of being administered only twice daily.