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At least 217 records · Page 12Linked to original sources

Azlocillin and the immune response in intensive care.

The authors have followed the course of the immunological cellular and humoral parameters in 12 patients in the Intensive Care Unit at the University Polyclinic of Messina having grave infections of the respiratory apparatus, for which an antibiotic therapy with azlocillin, semisynthetic penicillin was carried out; all this with the aim of pointing out any possible interferences with the already precarious immune system in such patients. The results obtained seem to exclude any immunodepressing activity by the molecule.

Adolescent↗

Ciprofloxacin versus tobramycin plus azlocillin in pulmonary exacerbations in adult patients with cystic fibrosis.

Twenty adult patients with cystic fibrosis who were experiencing acute pulmonary exacerbations were enrolled in a randomized, controlled trial comparing oral ciprofloxacin with intravenous tobramycin plus azlocillin. Efficacy of the two treatments was compared based upon changes in clinical status, pulmonary function tests, white blood cell counts, and quantitative bacteriology of sputum. No statistically significant differences were detected in these parameters of response between the two treatment groups (p greater than 0.05). Ciprofloxacin appears to be therapeutically equivalent to intravenous antibiotics in the treatment of adult patients with cystic fibrosis who are experiencing pulmonary exacerbations associated with susceptible bacteria.

Adult↗

Synergism of azlocillin, mezlocillin, piperacillin in combination with tobramycin against Klebsiella and Pseudomonas.

Fifty-three clinical isolates of Klebsiella and fifty-one clinical isolates of Pseudomonas aeruginosa, twenty-six of which were carbenicillin-(CARB) resistant, were tested for susceptibility to mezlocillin (MEZ), azlocillin (AZL), and piperacillin (PIP), both alone and in combination with tobramycin (TOB) using the microtiter broth diluent method and an inoculum density of 10(6) CFU/ml. The Klebsiella were highly resistant to TOB, MEZ, and PIP (MIC90: 8, greater than 256, greater than 128 micrograms/ml, respectively). Synergy was demonstrated in 53 percent (PIP/TOB) and 51 percent (MEZ/TOB). An indifferent response was observed in 47 percent (PIP/TOB) and 49 percent MEZ/TOB of the Klebsiella. PIP, MEZ, and AZL in combination with TOB showed synergism against CARB-resistant Pseudomonas in less than 10 percent of the strains tested. Synergy could be demonstrated against CARB-susceptible Pseudomonas with the combinations PIP/TOB, AZL/TOB, and MEZ/TOB in 12 percent, 12 percent, and 24 percent, respectively, of the twenty-five strains tested. Indifferent effects were observed in 84 percent, 88 percent, and 76 percent, respectively, of these same CARB-susceptible strains. These data suggest that there is no significant difference in the incidence of synergy with these new penicillins and tobramycin against either Pseudomonas or Klebsiella.

Azlocillin↗

[Pharmacokinetics of Azlocillin in premature and newborn infants (author's transl)].

In 13 newborns and 12 prematures the pharmacokinetic parameters of 6-[(R)-2-(2-oxo-imidazolidine-1-carboxamido)-2-phenyl-acetamido]-penicillanic acid sodium salt (azlocillin, Securopen), were investigated after a single i.v. load of 50 mg/kg body weight. From the concentration-time curve an open two-compartment model could be postulated. The values of the microconstants indicate that there is a rapid diffusion from the peripheral compartment into the central one. The elimination half-life calculated from the beta-slope is 2.6-2.5 h. differences between newborns and prematures are lacking. To reach an average steady-state concentration C-infinity between 50 and 80 microgram/ml plasma, 100-200 mg azlocillin/kg body weight during 24h must be given. The accumulation rates for a dosage interval of 6 or 8 h are 0.6 and 0.45.

Azlocillin↗

Effect of concentration and time upon inactivation of tobramycin, gentamicin, netilmicin and amikacin by azlocillin, carbenicillin, mecillinam, mezlocillin and piperacillin.

Carbenicillin and ticarcillin have been shown to inactivate aminoglycoside antibiotics. This study evaluated the effect of time upon in vitro interaction between mixtures of four aminoglycoside antibiotics at two concentrations with azlocillin, mecillinam, mezlocillin, piperacillin and carbenicillin at three concentrations. By linear regression analysis, the inactivation of each aminoglycoside antibiotic was shown to be directly proportional to the concentration of the semisynthetic penicillin. Aminoglycoside inactivation was greater after 72 hr of incubation with the penicillins than after 24 hr of incubation. Inactivation by each semisynthetic penicillin was greater for tobramycin and gentamicin than for netilmicin and amikacin, especially at higher concentrations of the penicillins. At concentrations of 500 microgram/ml, significantly less inactivation of amikacin occurred when compared to netilmicin. There was little difference in inactivation of a specific aminoglycoside by any of the semisynthetic penicillin antibiotics. No significant change in aminoglycoside activity occurred when the aminoglycosides were stored with the semisynthetic penicillin derivatives at -70 degrees C for 30 days. Conclusions from this study are: 1) serum specimens containing aminoglycoside-penicillin combinations should be tested immediately or frozen before antibiotic assay and 2) aminoglycoside inactivation by the newer semisynthetic penicillins may be important in patients with renal failure who are receiving these antimicrobial agents.

Amdinocillin↗

[Pharmacokinetic studies on the penetration of azlocillin and mezlocillin into bone and tissue fluid (author's transl)].

During and after hip replacement arthroplasty antimicrobial concentrations in serum, bone and tissue-fluid were determined microbiologically using agar diffusion assay technique after 15-min infusion of 5 g 6-[D-2-(2-oxoimidazolidine-1-carboxamido)-2-phenylacetamido] - penicillanic acid (azlocillin) and 5 g 6-[D-2-(3-methylsulfonyl-2-oxoimidazolin-1-ylcarboxamido)-2-phenylacetamido]-penicillanic acid (mezlocillin) and after i.v. bolus injection of 2 g mezlocillin. Serum pharmacokinetic data on the individual patients are computer derived using a modified open two-compartment model. The geometric mean of bone level determinations at defined intervals with deviation factor are presented. These results are related to the organic bone compartment and are expressed in mg/l. From the tissue fluid-concentration curve, peak concentration CP and its time were calculated. The time for which one-fourth of the peak concentration CP 1/4 was maintained in tissue fluid was determined graphically. This concentration is compared with the cumulative minimum inhibitory concentrations of representative bacteria causing bone and joint infections. These results are focused as criteria of valuation of antimicrobial chemotherapy.

Aged↗

Preoperative treatment with azlocillin in complicated urinary tract infections.

Eighteen patients, aged 18-84 years, with complicated urinary tract infections admitted to hospital were treated preoperatively with azlocillin (Securopen) for 5 to 10 days. Two patients having chronic pyelonephritis were not operated. Isolates bacteria were Pseudomonas aeruginosa (14), Proteus mirabilis (3), Escherichia coli (2) and Klebsiella spp. (1). Serum concentrations and urine recovery were measured on the fifth day of treatment. The mean serum half-life was 1.85 h and the mean value of the urine recovery 47% of the single dose. On the 5th day of treatment the urine was sterile in 80% of the patients. In 12 patients (60%) the urine was still sterile when controlled 2-6 months after operation and prophylactic postoperative treatment with nitrofurantoin or trimethoprim-sulfamethoxazole.

Adolescent↗

[Pharmacokinetics of azlocillin, a new semisynthetic, wide-spectrum antibiotic (author's transl)].

Azlocillin, a new semisynthetic penicillin with a wide spectrum of antimicrobial activity and a member of the ureidopenicillin group, was administered to ten adults in a dosage of 2 g by intravenous bolus injection. The determination of antibiotic activity in serum and urine demonstrated an average concentration of 58.9 mug/ml after one hour, 28.1 mug/ml after two hours and 6.1 mug/ml after four hours. The total urinary excretion was 60% within six hours. The pharmacokinetic parameters were calculated for the one and two compartment models, respectively. Mathematical analysis according to an open two-compartment model resulted in better curve adjustment as judged from the sum of the deviant squares. The resulting parameters for volume of distribution and rate of elimination show only minor differences however. Similar results were seen on comparison with the respective data for ampicillin.

Adult↗

[Treatment of pseudomonas infection with the new ureidopenicillin, azlocillin (author's transl)].

Azlocillin, in vitro four to eight times more effective against Pseudomonas aeruginosa than carbenicillin, was administered to 30 patients severely ill and having an additional pseudomonas infection. The drug was given at a dose of 4-6 g, in one case 8 g, per day, sometimes together with an aminoglycoside. Treatment was effective in 20, improvement occurred in five and failure only in four. In one instance the effect of the drug could not be evaluated. Results were particularly striking in septicaemia and necrotising external otitis. Pulmonary and wound infections in patients with circulatory disturbances did not respond so well. There were no serious side effects. The drug should not as yet be used at too high a dosage.

Adolescent↗

Agar disk diffusion susceptibility characteristics of azlocillin, carbenicillin, mezlocillin, piperacillin, and ticarcillin.

The agar disk diffusion susceptibility of Enterobacteriaceae to mezlocillin and piperacillin was correlated with agar minimal inhibitory concentrations and compared with the susceptibility to carbenicillin. The agar disk susceptibility of Pseudomonas aeruginosa to azlocillin, mezlocillin, and piperacillin was correlated with agar minimal inhibitory concentrations and compared with the susceptibility to carbenicillin and ticarcillin. Criteria are offered for the zones of inhibition to provide information about resistant and susceptible isolates that correlate with known serum levels.

Carbenicillin↗

The comparative synergistic activity of amikacin, gentamicin, netilmicin and azlocillin, mezlocillin, carbenicillin and ticarcillin against Serratia marcescens.

The synergistic activities of netilmicin, gentamicin and amikacin combined with carbenicillin, ticarcillin, azlocillin and mezlocillin were investigated against 32 Serratia marcescens isolates. Synergy could be demonstrated by killing curve technique, isobologram plots as susceptibility data with any of the aminoglycosides and penicillins combinations. No antagonism was shown with any of the combinations. The majority of the isolates were resistant to the aminoglycosides and penicillins. Combination of either ureido-penicillin or carbenicillin with gentamicin or netilmicin did not reduce the MIC values to levels achievable in serum but did reduce the MIC levels of both agents to those achievable in urine. The combination of ureido-penicillins or carbenicillin and ticarcillin with amikacin reduced the inhibitory levels of all isolates to levels achievable in both serum and urine.

Amikacin↗

[Neutropenia as side effect of azlocillin in an infant (author's transl)].

The authors report on a case of severe neutropenia in an infant treated with azlocillin. This case fits well into the series of wellknown reports on hematologic side effects of other semisynthetic penicillins, with regard to the onset of symptomatics, clinical side effects, and full reversibility.

Agranulocytosis↗