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Biomedical subjects

R A Benn

Publications and source records attributed to R A Benn.

23 records · Page 2Linked to original sources
PubMedDate not supplied

Treatment of tuberculosis in Australia.

The combination of isoniazid and rifampicin, initially accompanied by a third drug such as ethambutol, has become the standard treatment for pulmonary tuberculosis in Australia. Not all patients need admission to hospital but careful follow-up and encouragement of compliance with the regimen is important during the year of therapy which follows the diagnosis of the disease. Because of the higher incidence of drug resistance in disease acquired in Southeast Asia, a fourth drug, usually pyrazinamide, is added until the results of sensitivity testing are known. Pulmonary disease caused by environmental ("atypical") mycobacteria presents special problems in treatment because the infection usually complicates pre-existing lung disease; drug resistance is the rule; and there are no well controlled prospective trials to provide a rational basis for therapy.

Adult↗
PubMedDate not supplied

Bacteremia and bacterascites after endoscopic sclerotherapy for bleeding esophageal varices and prevention by intravenous cefotaxime: a randomized trial.

Thirty-one patients were randomized during 39 episodes of bleeding to receive either 1 g of intravenous cefotaxime (19 patients) or no antibiotic (20 patients) immediately before emergency endoscopic sclerotherapy. Blood was obtained for culture before and at 5 minutes, 4 hours, and 24 hours after the procedure. Specimens for culture were taken from the endoscope tip and channel, water bottle, and injection needle after sclerotherapy. When ascites was present (5 patients in the antibiotic group, 7 in the control group), fluid was obtained by paracentesis before endoscopy and at 4 and 24 hours. Bacteremia occurred in 1 of 19 patients in the antibiotic group (5.3%), compared with 6 of 19 in the control group (31.6%; p = .04). The cultured organisms were oral flora and usually also contaminated the endoscope and needle. No bacteria were cultured from ascitic fluid in any patient nor was the ascitic fluid white cell count elevated. Clinical infection attributable to sclerotherapy did not develop in any patient. In conclusion, the frequency of bacteremia after endoscopic sclerotherapy for bleeding esophageal varices can be reduced by prophylactic administration of intravenous cefotaxime. However, this may not be clinically relevant, given the absence of bacterascites and infection in this study. These findings do not support the routine use of antibiotics before sclerotherapy.

Ascites↗