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S J Childs

Publications and source records attributed to S J Childs.

At least 19 recordsLinked to original sources
PubMed1992

A multicenter comparison of oral lomefloxacin versus parenteral cefotaxime as prophylactic agents in transurethral surgery.

This report presents the pooled results from two randomized trials of lomefloxacin and cefotaxime used as prophylaxis in patients undergoing transurethral surgical procedures. A total of 499 patients were enrolled at seven centers in the United States. Patients received either 400 mg of lomefloxacin orally 2-6 hours prior to surgery, or 1 g of cefotaxime intravenously or intramuscularly 30-90 minutes preoperatively. Patients undergoing simple cystoscopy or retrograde pyelograms were not eligible for inclusion. Urine cultures were obtained prior to surgery, 24 hours post-surgery, prior to catheter removal, and 3-5 days post operatively. Treatment failure was defined as isolation of greater than or equal to 10(5) colony-forming units (CFU)/mL of pathogenic bacteria from any post-surgical urine culture. Lomefloxacin was successful in preventing post operative infections in 204 of 207 evaluable patients (98.6%); there were three prophylactic failures. Cefotaxime was successful in 196 of 206 (95.1%) evaluable patients; 10 were prophylactic failures. Lomefloxacin concentrations were measured simultaneously in serum and in samples of prostate tissue from 29 patients undergoing transurethral resection of the prostate. Lomefloxacin prostate concentrations were 1.0-22.3 micrograms/g, with a mean of 5.0 micrograms/g. The average tissue:plasma ratio was 2.0. The safety profile of the two study drugs was excellent, and both were well tolerated. Adverse events were reported by 12.7% of the patients treated with lomefloxacin and 13.8% of those treated with cefotaxime. The majority of events were mild and required no treatment.

Administration, Oral↗
PubMed1991

Current concepts in the treatment of urinary tract infections and prostatitis.

Urinary tract infection is a common medical diagnosis. The decision to treat is based on presenting signs and symptoms, bacterial colony counts in urine, and the nature of the infection. Escherichia coli is the single most frequent cause of urinary tract infections, although, depending on the clinical presentation and presence of risk factors, other pathogens may also be implicated. A variety of antimicrobial agents are available for the treatment of urinary tract infections. Fluoroquinolones are useful because these agents have broad-spectrum antimicrobial activity, resistance to these agents is minimal, and they achieve high concentrations in the urinary tract, have long elimination half-lives in urine, and are well tolerated.

4-Quinolones↗
PubMed1991

Treatment of chronic bacterial prostatitis with temafloxacin.

In an open multicenter study [corrected], 112 male patients (mean age 47.1 years) with documented symptomatic chronic bacterial prostatitis were treated with oral temafloxacin 400 mg b.i.d. for 28 days. Urine and prostatic secretions were obtained for culture and susceptibility testing, and clinical signs and symptoms were evaluated at day 14 as well as 5-9 days and 26-30 days post-treatment. The most frequently isolated pretreatment pathogens (n = 97) were 36 strains (38%) of Escherichia coli and 16 strains (17%) of Enterococcus. Clinical success (cure plus improvement) was demonstrated in 74 of 81 (91%) patients at visit 4, 5-9 days post-treatment and at visit 5, 26-30 days post-treatment in 61 of 71 (86%) patients. At visit 4, 94% of patients had eradication of pretreatment pathogens. At visit 5, 92% had continued eradication of their original pathogens. Improvement was observed in the severity of signs and symptoms that existed pretreatment at visit 4 (visit 5): dysuria, 92% (93%); perineal pain, 95% (93%); lower abdominal pain, 93% (100%); lower back pain, 88% (93%); scrotal/penile pain, 91% (83%). Digestive system (6.3%) and nervous system (4.5%) adverse events were observed most frequently. Temafloxacin 400 mg b.i.d. administered orally for 28 days represents a safe and effective treatment for chronic bacterial prostatitis.

Adult↗
PubMed1990

Treatment of recurrent urinary tract infection with norfloxacin versus trimethoprim-sulfamethoxazole.

Norfloxacin, a broad-spectrum antimicrobial analog of nalidixic acid, was evaluated by comparing it to trimethoprim-sulfamethoxazole in 93 office patients with recurrent urinary tract infections. In this prospective randomized study, norfloxacin and trimethoprim-sulfamethoxazole were given on the same dosage schedule with the former drug given as a 400-mg tablet twice daily and the latter drug given as a double strength tablet twice daily. Overall, 50 patients received norfloxacin and 43 patients received trimethoprim-sulfamethoxazole with a cure rate of 96 percent and 79 percent, respectively. Whether a patient had one infection or multiple previous infections, norfloxacin appeared to be superior to trimethoprim-sulfamethoxazole. Only minor side effects were noted in either group, and no patient withdrew from this study as a direct result of these side effects. Minor complaints of nausea, dizziness, and headache were found in the norfloxacin group (24%) and in the trimethoprim-sulfamethoxazole group (16%). Both agents are effective in treating urinary tract infections but norfloxacin is superior to trimethoprim-sulfamethoxazole in patients with either recurrent complicated infections or one previous uncomplicated urinary tract infection.

Adult↗
PubMed1989

A multicenter, double-blind, trimethoprim-sulfamethoxazole controlled study of enoxacin in the treatment of patients with complicated urinary tract infections.

In a double-blind, randomized, controlled trial, 249 patients with complicated urinary tract infections received either 400 mg. enoxacin or 160 mg. trimethoprim plus 800 mg. sulfamethoxazole orally every 12 hours for 14 days. The clinical outcome at the end of treatment revealed that all 89 evaluable patients (100 per cent) in the enoxacin group and 88 of 90 (98 per cent) in the trimethoprim-sulfamethoxazole group had satisfactory clinical responses (cure or improvement). Bacteriological effectiveness was measured cumulatively based on responses during and at the end of treatment, and 7 days later at followup. Satisfactory bacteriological responses (eradication or superinfection at all evaluations throughout the study) were achieved in significantly more (p equals 0.03) patients treated with enoxacin (93 per cent) than in those treated with trimethoprim-sulfamethoxazole (83 per cent). Both study medications were well tolerated. These results indicate that oral enoxacin was more effective clinically and bacteriologically (the latter statistically so) than trimethoprim-sulfamethoxazole when given as empiric therapy in the treatment of complicated urinary tract infections.

Adult↗
PubMed1989

Tissue penetration and clinical efficacy of enoxacin in urinary tract infections.

The fluoroquinolones in general, and particularly enoxacin, show great promise in the treatment of urinary tract infection. Orally administered enoxacin achieves high concentrations in the serum and urine as well as in prostate tissue, kidney and perirenal fat and muscle. These concentrations are generally in excess of the minimum inhibitory concentrations (MIC) for 95% of the common uropathogens, including Escherichia coli, Pseudomonas aeruginosa, Klebsiella spp., Proteus spp., Enterobacter spp., Serratia marcescens and Staphylococcus saprophyticus. In comparative clinical trials, treatment with oral enoxacin has achieved satisfactory clinical results (symptoms improved or absent) in 67 to 96% of patients and satisfactory bacteriological results (less than 10(4) colony count of the original bacteria) in 77 to 98% of patients. Clinical cure or improvement occurred in 94 to 100% of patients in uncontrolled trials, with corresponding satisfactory bacteriological results of 82 to 100%. In a number of studies of patients with difficult-to-treat infections, satisfactory clinical results were achieved in 92 to 100% of patients and satisfactory bacteriological results in 89 to 100% of patients.

Enoxacin↗
PubMed1988

Management of urinary tract infections.

Community-acquired urinary tract infections account for millions of physician visits per year. When urinary tract infections develop in hospitalized patients, they not only increase the duration of hospitalization (and thus its cost) but also have a serious and sometimes devastating impact on the incidence of morbidity and mortality. Treatment depends on the clinical setting, the causative organism, the site of infection, and the patients' host defenses. Diagnosis and subsequent appropriate classification provide important information on which to base therapeutic decisions. Simple first infections, particularly in women, generally respond to treatment with a simple antibiotic drug. Complicated or recurrent infections, in contrast, require other therapeutic strategies.

Adult↗
PubMed1987

Antibiotic genitourinary surgical prophylaxis.

Urologists continue to use antibiotics inappropriately. We should rethink the reasons why certain attitudes exist about powerful drugs for prophylaxis and adjust our prescribing habits for therapy as well. Using catheters and urethral instrumentation sparingly and only when necessary, while employing proper infection control techniques and judicious antibiotic prophylaxis can control the nosocomial infections resulting from genitourinary surgery.

Anti-Bacterial Agents↗
PubMed1986

Upper and lower urinary tract infections: amikacin's role in managing surgical complications.

Approximately one out of every 40 patients admitted to United States hospitals each year acquires a urinary tract infection while hospitalized. Urologic instrumentation is the precipitating cause in 75 to 80 percent of the cases. Such infections are responsible for a mortality rate among these patients that is three times the rate observed for all other hospitalized patients. When associated with gram-negative bacteremia, nosocomial urinary tract infections can progress rapidly to an irreversible state, resulting in death in 10 percent of those patients affected. Survivors are faced with escalating costs of hospital care and drug therapy. Presumptive administration of antibiotics is routinely recommended in selected types of genitourinary surgery, primarily because of the contaminated nature of the procedures, and especially advised when the surgery is likely to be followed by the placement of an indwelling urinary catheter. Quite often, the regimen for presumptive treatment of urinary tract infections includes aminoglycosides, such as amikacin, alone or in combination. The role of amikacin in empiric management of postoperative urinary tract infections is even more obvious. The fact that it has the broadest spectrum of activity compared with other aminoglycosides reduces the chance of therapeutic failure and results in a shorter hospital stay. In that respect, amikacin may effect an overall decrease in total costs of hospitalization.

Amikacin↗
PubMed1986

Treatment of bacterial prostatitis. Comparison of cephalexin and minocycline.

The relative safety and efficacy of minocycline and cephalexin were examined in patients with acute or chronic prostatitis. The multicenter study was of single-blind, parallel-group design. Forty-two men received minocycline (200-mg initial dose followed by 100 mg twice daily) and 44, cephalexin (500 mg four times daily); each antibiotic was administered orally for four weeks. A follow-up period of patient assessment extended for an additional six weeks. Evaluable data were available for 20 minocycline-treated patients and for 24 cephalexin-treated patients. Clinical cure or improvement without recurrence was seen in 65 per cent of the patients who received minocycline and in 46 per cent of those given cephalexin. Bacteriologic cure without relapse or reinfection occurred in 45 per cent of the minocycline-treated men and in 21 per cent of the cephalexin-treated men. Serious adverse clinical experiences were not encountered in either treatment group. Although several factors, mainly the small number of patients, precluded a statistical analysis of comparative efficacy, it was evident that more patients in the minocycline-treated group had both clinical and bacteriologic cures (35%) than did those in the cephalexin-treated group (21%).

Adolescent↗
PubMed1986

Appropriate surgical prophylaxis in transurethral genitourinary surgery and potential reduction in nosocomial infections.

Despite the high rate of urinary tract infections seen in hospitals, until recently many surgeons did not advise antibiotic prophylaxis for transurethral genitourinary surgery. This situation has changed with the realization that older trials with questionable results were poorly designed. Several recent well-controlled clinical studies show that appropriate antibiotic prophylaxis greatly reduces the high incidence of infections following transurethral genitourinary surgery. Effective antibiotic prophylaxis for transurethral operations may be a major route to substantial reduction in nosocomial urinary tract infections and bacteremia. To achieve effective prophylaxis, the surgeon must choose a correct antibiotic and use it according to proved principles.

Anti-Bacterial Agents↗
PubMed1985

Aztreonam in the treatment of urinary tract infection.

The possible advantages of the monobactam antibiotic aztreonam in the treatment of hospital-acquired urinary tract infection were assessed in a study comparing aztreonam (0.5 to 1 g twice daily or three times daily) to cefamandole (1 g three times daily) in 159 patients. Initial pathogens were eradicated in 91.7 percent of the patients of the aztreonam group who were treated three times daily, in 82.7 percent of the group treated twice daily, and in 78.3 percent of the patients receiving cefamandole. Reinfection and superinfection were most commonly caused by enterococci in the aztreonam groups and by Pseudomonas aeruginosa in the cefamandole group. In a second study, 35 patients infected with organisms resistant to other antibiotics were treated with aztreonam 1 to 6 g per day for eight days. The overall cure rates were 93 percent for Pseudomonas infections, 87.5 percent for Escherichia coli infections, and 100 percent for other pathogens.

Anti-Bacterial Agents↗
PubMed1985

Perioperative mezlocillin vs cefotaxime to prevent infections after genitourinary surgery.

This is a report of a randomized, comparative, double-blind study of mezlocillin and cefotaxime given perioperatively to 100 patients undergoing genitourinary surgery. Of 94 evaluable patients, 2 (4.7%) in the mezlocillin group and 2 (3.9%) in the cefotaxime group infections developed in the immediate postoperative period. The difference in these incidences is not statistically significant. One patient with recent bacterial prostatitis and prostatic calculi received cefotaxime and bacteriuria and sepsis developed on the first postoperative day.

Adult↗