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Biomedical subjects

W Brumfitt

Publications and source records attributed to W Brumfitt.

At least 73 records · Page 4Linked to original sources
PubMed1988

In-vitro microbiological activities of DuP 105 and DuP 721, novel synthetic oxazolidinones.

DuP 105 and 721, synthetic antibiotics belonging to a totally novel chemical class (oxazolidinones), have been found to be active in vitro against a wide range of Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus. DuP 721 had geometric mean MICs ranging from 1.1 to 16 mg/l against 167 strains of Staph. aureus, Staph. epidermidis, Staph. saprophyticus, streptococci of Groups A, B and D and diphtheroids. DuP 105 was between 1.5 and eight-fold less active. Bacteroides fragilis strains were also susceptible to the DuP compounds (mean MICs being 8.3 and 14.9 mg/l for DuP 721 and 105, respectively), but other Gram-negative species and yeasts were not inhibited by concentrations in excess of 100 mg/l. Both compounds had a predominantly bacteriostatic action. No primary resistance was found, and the incidence of resistant variants in 105 strains tested was less than 1 per 10(8) bacteria.

Anti-Bacterial Agents↗
PubMed1988

Efficacy and safety of teicoplanin in gram-positive peritonitis in patients on peritoneal dialysis.

Twelve cases of peritonitis caused by Gram-positive bacteria in 11 dialysis patients were treated with teicoplanin. Treatment, which was continued for three weeks, consisted of the addition of teicoplanin to the dialysis fluid. Six patients who were febrile on admission were also given a single intravenous dose of 400 mg teicoplanin. For patients on continuous ambulatory peritoneal dialysis 20 mg teicoplanin per litre was added to each dialysis bag during the first week of treatment, to alternate bags during the second week, and only to the overnight dwell bag in the third week. For patients on intermittent peritoneal dialysis, 20 mg/l teicoplanin was added at each dialysis session. Resolution of peritonitis occurred in all patients within one to five days (mean 2.2); nine were discharged within this period and the patients continued to treat themselves at home. The other two patients were kept in hospital for reasons unconnected with the peritonitis. Nine patients have remained well at follow-up 2-13 months (mean 6.3) later. Two patients, both of whom had Staphylococcus aureus peritonitis, relapsed three months after the end of treatment. Mean serum teicoplanin concentrations were less than 10 mg/l, except in one patient who was re-treated when he relapsed. No adverse effects were recorded; one patient who developed a conductive hearing loss was found to have otitis media and obstruction due to wax. We conclude that teicoplanin is safe and effective in treating peritonitis in patients on peritoneal dialysis.

Anti-Bacterial Agents↗
PubMed1988

The changing face of chemotherapy.

The historical development of antibiotics has been summarized. Three distinct phases are discernible. The first (from historical times to about 1900) involved mostly folk remedies. The second (1900-c. 1940) was ushered in by Paul Ehrlich's development of the concept of 'selective toxicity' and saw the establishment of arsenicals and sulphonamides. The third, lasting to the present day, started with the exploitation of the pioneering studies of Fleming, Dubos and Waksman on antibiotic production by soil fungi. This latest phase has continued with the improvement of natural products by the skills of the medicinal chemist. The properties and evolution of three major groups of antibiotics, penicillins, cephalosporins and aminoglycosides are fully described. Finally, pathways of possible future evolution of antibiotics are outlined.

Anti-Bacterial Agents↗
PubMed1987

Periurethral enterobacterial carriage preceding urinary infection.

The periurethral enterobacterial flora was identified before infective episodes in 56 patients with recurrent urinary infection. There were 91 episodes of infection, with colonisation by aerobic gram-negative bacilli in 60. In only 31 (34%) episodes were patients colonised with the infective strain. In 31 episodes there was no colonisation of the perineum and in 29 there was heterologous colonisation. In another group of 54 women investigated during an enterobacterial infection of the urine there was colonisation with the infecting organism in 55 (86%) of 64 episodes; in 2 there was no colonisation; and 7 (11%) were associated with a heterologous strain. Women who have recurrent urinary infections are susceptible to perineal and periurethral colonisation with gram-negative bacteria but the infection need not be with the colonising enterobacteria.

Adolescent↗
PubMed1987

Recurrent urinary infections in women: clinical trial of cephradine as a prophylactic agent.

Cephradine 250 mg at night for 12 months was given as a prophylactic measure to 33 female patients of mean age 41.6 years, who had a history in the preceding 12 months of between three and 24 (median = 7) episodes of frequency and/or dysuria. When on such treatment the mean period between symptomatic attacks was 300 days, while before treatment attacks occurred at a mean frequency of 60.3 days. Thus, prophylactic cephradine increased the interval between attacks five-fold. In a total of 9002 patient-days of treatment, only five bacteriuric breakthrough infections occurred. 27% of the patients reported adverse effects "probably" or "possibly" related to treatment. Hence, cephradine appears to be as effective and better tolerated than macrocrystalline nitrofurantoin, presently the drug of choice for the prophylaxis of recurrent urinary infections.

Adult↗
PubMed1987

Teicoplanin in patients with chronic renal failure on dialysis: microbiological and pharmacokinetic aspects.

A significant increase in the incidence of methicillin resistance was found in coagulase-negative staphylococci isolated from infected dialysis fluids in 1985 compared with the previous year. Vancomycin and teicoplanin were active against all these isolates, and had similar minimum inhibitory and bactericidal concentrations. The pharmacokinetic behaviour of teicoplanin in 23 dialysis patients was studied. A single, intravenous dose of teicoplanin was given to 11 patients on haemodialysis (HD) and seven patients on chronic ambulatory peritoneal dialysis (CAPD). In five CAPD patients, 40 mg was added to each 2 litre bag of dialysate for a five day period. Twenty such bags were exchanged. The study showed that a) teicoplanin was not removed from the body by HD or CAPD, b) less than 3% of the administered dose appeared in the urine, c) serum levels reached a plateau of 3-4 micrograms/ml after 40 hours and were maintained for at least five days, regardless of the route of administration or form of dialysis. These findings have obvious implications regarding appropriate treatment regimens in dialysis patients.

Adult↗
PubMed1986

Effect of amoxicillin-clavulanate and cephradine on the fecal flora of healthy volunteers not exposed to a hospital environment.

A 7-day course of either cephradine or amoxicillin-clavulanate treatment caused no significant change in fecal flora composition, except that staphylococci were virtually eliminated in both groups. Some amoxicillin-resistant coliforms were isolated after treatment in both groups, but cephradine- or amoxicillin-clavulanate-resistant coliforms were rarely isolated.

Amoxicillin↗