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PubMed1983

[Fundamental and clinical studies on T-1982 (cefbuperzone), a new cephamycin antibiotic, in the field of pediatrics].

Studies on T-1982 (cefbuperazone), a new cephamycin antibiotic, were carried out in the field of pediatrics, and the following results were obtained. 1. Peak MIC of T-1982 against S. pyogenes (group A) lately isolated was 0.39 micrograms/ml, and the drug was active even against highly resistant strains of macrolides, lincomycin, tetracycline and chloramphenicol. 2. Peak MICs of T-1982 were 0.78 microgram/ml against B. pertussis, 0.2 microgram/ml against E. coli and less than or equal to 0.05 microgram/ml against K. oxytoca, and the drug was also active against ampicillin-resistant bacteria. 3. Serum levels and urinary excretions of T-1982 were investigated in 6 cases. When given at a dose of 20-28 mg/kg by 1 hour intravenous drip infusion, serum concentrations of T-1982 attained the peak level of 63.5-75.9 micrograms/ml at the end of administration and sustained the level of 0.9-2.6 micrograms/ml at 6 hours, the serum half-life (T 1/2) ranging 70-82 minutes. Approximately 20-72% of the dose were excreted in the active form into urine within 6 hours. 4. Twenty-seven cases of acute pediatric infections were treated with T-1982 mainly by intravenous drip infusion, and satisfactory clinical results were obtained in all the cases of angina lacunaris, bronchitis, bronchopneumonia, pertussis, sepsis caused by Serratia and acute urinary tract infections caused by ampicillin-resistant E. coli. The efficacy rate was 96.3%. In this study the drug was administered chiefly at a daily dose of 50-70 mg/kg 2-3 times a day for 2-12 days. 5. Gram-positive cocci (S. aureus, S. pneumoniae, S. pyogenes) and Gram-negative rods (H. influenzae, H. parainfluenzae P. vulgaris, B. pertussis, S. marcescens, E. coli) were eradicated by the treatment with T-1982. 6. No noticeable side effects were observed, except for temporary increase of eosinophil in 2 cases and slight elevation of GOT in 1 case.

Anti-Bacterial Agents↗
PubMed1983

Total intestinal decontamination for prevention of infection in bone marrow transplantation.

In an attempt to prevent infections complicating bone marrow transplantation, 22 patients received oral nonabsorbable antibiotics in protected environments. The standard antibiotic regimen consisted of gentamicin, vancomycin and nystatin. The vast majority of fecal organisms initially cultured were completely suppressed by about one week after initiation of antibiotic prophylaxis. The antibiotics had to be taken regularly to keep the gastrointestinal tract decontaminated. However, Candida was often cultured despite prophylaxis. The best method for continuously suppressing Candida was considered to be administering an adequate antifungal drug before intestinal decontamination. The throat, however, was far more difficult to decontaminate than the stool. Lincomycin inhalation was most effective in suppressing anaerobic bacteria. Some of the organisms cultured persistently or intermittently from the throat tended to appear sooner or later in the stool during prophylaxis, although they were not always resistant. The pattern of reappearance of the fecal flora after intestinal decontamination was similar to that observed in newborn infants. However, none of the Enterobacteriaceae strains which reappeared in the stool were identical to those cultured initially. Absorption of gentamicin and vancomycin from the gastrointestinal tract was negligible. A gentamicin-induced small-colony variant of Klebsiella pneumoniae was isolated from one patient. Amphotericin B was more tolerable than nystatin, which often produced nausea and vomiting in association with the preparative radio-chemotherapy for marrow transplantation. Hypoprothrombinemia and hypocholesterolemia were noted during prophylaxis. Three episodes of exogenous bacterial infection occurred despite strict isolation procedures.

Adolescent↗
PubMed1983

[In vitro activity of josamycin in a comparison of Staphylococcus aureus, Streptococcus pyogenes and Streptococcus pneumoniae].

The antibacterial effect of josamycin has been tested in vitro on strains of S. Aureus, Str. Pyogenes and Str. Pneumoniae isolated during 1981 from human liquor, blood and purulent secretions. It is confirmed that even modest doses of the antibiotic have this effect upon S. Aureus strains which are resistant to several antibiotics including erythromycin and lincomycin. In some cases, although bacteriostasis occurred, bacterial survival indices were fairly modest.

Dose-Response Relationship, Drug↗
PubMed1983

[Antibiotic sensitivity of beta-hemolytic Streptococcus group A on a new nutrient medium for the cultivation of streptococci].

Sensitivity of 167 strains of beta-hemolytic streptococci of group A was studied with the method of serial dilutions on a solid agar medium for cultivation of streptococci. The medium was developed at the I. I. Mechnikov Research Institute of Vaccines and Sera. It does not require addition of blood or serum. The strains were found to be highly sensitive to penicillin, cephalothin and erythromycin. The number of the strains resistant to tetracycline, streptomycin, gentamycin, levomycetin (chloramphenicol) and ristomycin amounted to 51, 36, 23, 1.8 and 1.8 per cent, respectively. One of the strains (0.6 per cent) was resistant to lincomycin. Strains with multiple resistance were isolated. The necessity of regular control of distribution of antibiotic resistance among staphylococci is indicated.

Anti-Bacterial Agents↗
PubMed1983

Frequency and resistance patterns of bacterial isolates from surgical patients in a teaching hospital in Addis Ababa.

Specimens from surgical patients in a teaching hospital in Addis Ababa were processed for aerobic culture; 2654 isolates were tested for their sensitivities to 11 antibiotics using the Kirby-Bauer technique. Proteus, E. coli, S. aureus, Klebsiella and Pseudomonas comprised over 80% of the isolates. Only gentamicin, polymyxin B, kanamycin and trimethoprim-sulphamethoxazole were effective against the majority (over 70%) of the Gram-negative isolates. Over 85% of the S. aureus strains were susceptible to gentamicin, kanamycin, trimethoprim-sulphamethoxazole, cephalothin and lincomycin. All B-haemolytic streptococci were susceptible to penicillin and 77% to tetracycline. Between 70% and 90% of the Gram-negatives were multiple resistant, with greatly varied resistance patterns. A few types occurred more frequently. The findings of high rates of resistance to the many antibiotics underscore the need for a policy that should promote a more rational use of antibiotics.

Anti-Bacterial Agents↗
PubMedDate not supplied

Antimicrobial susceptibility and susceptibility testing of Mycoplasma hominis: a review.

The determination of the minimal growth-inhibiting concentration (MIC), the minimal metabolism-inhibiting concentration (MMC), and the minimal mycoplasmacidal concentration (MCC) of various antimicrobial compounds for Mycoplasma hominis is influenced by the pH of the test media, the inoculum size, and the incubation time, although each of these factors generally do not affect the minimal concentration more than fourfold. M. hominis is resistant to beta-lactam antibiotics, vancomycin, sulfonamides, trimethoprim, and polymyxin B. There are great differences in the susceptibility of M. hominis to various macrolide antibiotics. Thus the organism is resistant to erythromycin and oleandomycin, moderately resistant to tylosin and spiramycin, susceptible to josamycin as well as to another macrolide drug, labelled M-4365G. M. hominis is also highly susceptible to the macrolide-like compound rosaramicin and to the tetracyclines (although resistant strains occur). It is susceptible to lincomycin and clindamycin, and moderately susceptible to chloramphenicol and rifampicin. The aminoglycosides have limited activity against M. hominis.

Anti-Bacterial Agents↗
PubMed1978

[Antibacterial therapy of liver abscesses of varying etiology].

The investigation of microbial flora and its sensitivity in 196 patients with the kidney abscesses of various etiology showed expediency of the use of aminoglycosides, ampicillin and lincomycin. The local use of colloid iodine promoted rapid inhibition of the microbial flora. The dynamic observations showed an increase in the number of gramnegative pathogens by the 7th--10th day of the treatment. Rational surgical intervention, the antibiotic use with control of the microbial flora sensitivity, specific chemotherapy provided a decrease in the lethality up to 6.7 per cent.

Anti-Bacterial Agents↗
PubMed1980

[Sensitivity of the causative agents of suppurative-inflammatory diseases to medical bacteriophages].

Sensitivity to therapeutic bacteriophages and antibiotics of 2063 cultures causing purulent inflammatory diseases was studied. Sensitivity of Staph. aureus to therapeutic bacteriophages was higher (88.5%) than that to benzylpenicillin (33.7%), ampicillin (64.3%), erythromycin (53.7%) and close to that to aminoglycosides, tetracycline, lincomycin and chloramphenicol. The number of Ps. aeruginosa strains sensitive to the phages amounted to 67.1%. E. coli and Proteus were sensitive to therapeutic bacteriophages in 32.4 and 29% of the cultures respectively. All of the streptococcal strains isolated from the patients were resistant to phages. A favourable clinical effect of phages was observed in 37 out of 80 patients. The results of the study showed the advisability of the wide use of bacteriophages in combined treatment of purulent inflammatory diseases.

Anti-Bacterial Agents↗
PubMed1978

Clinical relevance of the effect of hepatic disease on drug disposition.

The effect of hepatic disease on the metabolism of drugs is reviewed. Drugs discussed include those acting on the central nervous system (phenobarbital, pentobarbital, amobarbital, diazepam, chlordiazepoxide, oxazepam, clorazepate, chlorpromazine, morphine, meperidine, phenytoin); those acting on the cardiopulmonary system (digoxin, digitoxin, lidocaine, theophylline); antineoplastic agents (azathioprine, 6-mercaptopurine, doxorubicin), antimicrobials (carbenicillin, ampicillin, nafcillin, chloramphenicol, clindamycin, lincomycin, rifampin, isoniazid, aminosalicylic acid) and antiinflammatory agents (phenylbutazone, prednisone). The effect of hepatic dysfunction on drug disposition is not consistent or predictable. The efficiency with which drugs are metabolized by the liver, the extent of drug plasma binding, and the etiology and stage of the hepatic disorder are each important in determining whether drug disposition will be altered.

Anti-Infective Agents↗
PubMed1984

[Therapy and prevention of infectious endocarditis].

Only 40 years ago infectious endocarditis (IE) was lethal in most cases. Due to the development of numerous antibiotics and continuous improvements in heart valve surgery, a wide range of possibilities for therapy and prophylaxis of IE are available. The prognosis depends essentially on rapid and relevant diagnosis, which should be followed by immediate and adequate therapy consisting of general measures for treatment of septicaemic disease and specific antibiotic therapy. As multiple complications may develop during IE, careful follow-up by clinical, laboratory and mechanical examinations is necessary to decide whether surgical intervention is urgently indicated or not. In case of complications such as myocardial failure, septicaemic embolism or acute renal failure, as well as septicaemia persisting for more than 72 hours in spite of antibiotic treatment, immediate valve replacement is usually indispensable. Furthermore, large vegetations found by echocardiography, or infections caused by staphylococci, gramnegative bacteria or fungi are arguments for early surgery. For most of the IE pathogens the antibiotic treatment concept is nowadays widely acknowledged. Penicillin-sensitive streptococci are treated with a combination of penicillin S and an amino-glycoside (streptomycin). If the penicillin-MBK is very low, combined treatment can usually be abandoned. In patients allergic to penicillin, treatment with lincomycin has advantages over vancomycin or cephalosporins. In enterococcal IE, ampicillin plus aminoglycoside is the combination of choice. Streptomycin has preference over gentamicin here only if the enterococci are not streptomycin-resistant. If penicillin allergy is evident, the new beta-lactam antibiotic imipenem offers a way out of the present therapy dilemma. For penicillin-sensitive staphylococci a combination of penicillin-G with gentamicin given over 6 weeks is recommended. In case of penicillin allergy, cefazolin or vancomycin may provide a substitute for penicillin. In penicillin-resistant staphylococci the combination of oxacillin or flucloxacillin with gentamicin is established. Fungal endocarditis can be treated with a combination of amphotericin-B and flucytosin. Cure without surgery, however, is rare. For the large remaining number of pathogens which are less frequently responsible for IE, antibiotic management depends on sensitivity test in vitro, as the sensitivity of pathogens may vary widely. Though not only groups of patients with high infection rates are widely known, but also the events provoking the infections, the prophylaxis of IE continues to be inadequate.(ABSTRACT TRUNCATED AT 400 WORDS)

Anti-Bacterial Agents↗
PubMed1984

Use of antibiotics in dental practice.

Penicillin G administered parenterally or penicillin V administered orally are currently the antibiotics of choice for treatment of dental infections of usual etiology. Infections caused by penicillinase-producing staphylococci or those involving gram-negative bacteria should be treated with a penicillinase-resistant penicillin or an ampicillin-like derivative, respectively. Erythromycin is a second-choice bacteriostatic antibiotic, becoming first choice for treating dental infections in patients allergic to penicillin. The cephalosporins, similar in action to ampicillin-like penicillin derivatives, may be used with caution in patients who have exhibited delayed-type allergic reactions to penicillin and when erythromycin cannot be used. Their lack of advantage over other agents, and their cost, precludes routine use for usual dental infections. Clindamycin administered orally or lincomycin administered parenterally are reserve antibiotics indicated for treatment of bone infections and/or anaerobic infections refractory to commonly used antibiotics. Tetracyclines are, at best, third-choice agents for usual dental infections. However, they are useful for cases of acute necrotizing ulcerative gingivitis requiring systemic antibiotic therapy when penicillin is precluded. Vancomycin and streptomycin are used prophylactically for prevention of infective endocarditis in patients with prosthetic heart valves. Nystatin remains a first-choice agent for treatment of oral candidal infections. Ketoconazole, an orally active systemic antifungal agent, may be used for monilial infections of the oral cavity refractory to nystatin. Chemotherapy of viral infections is difficult because of the timing of events of the disease process versus appearance of clinical symptoms and lack of effective agents with selective toxicity. Herpes infections of the oral cavity have been treated--with limited success--with idoxuridine. Acyclovir, a newer antiviral drug, offers little clinical benefit for herpes infections in usually healthy patients but may be of value for treating such infections in immunocompromised patients. All antimicrobial agents may cause adverse reactions of varying degrees of severity. Most orally administered antibiotics may cause gastrointestinal disturbances. Superinfections occur with broad-spectrum antibiotics and a severe form of superinfection, antibiotic-associated colitis, has occurred with almost all antibiotics. Allergic reactions of all degrees of severity can occur with most antibiotics. The penicillins, followed by the cephalosporins and tetracyclines, are most frequently implicated in these reactions.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1983

Antibiotic treatment of staphylococcal septicaemia and endocarditis in a Swedish hospital.

In a retrospective study covering the years 1977 to 1981, the results of antibiotic treatment in 123 patients with staphylococcal septicaemia with or without endocarditis have been analysed. 80 patients (mean age 60 years) were non-drug addicts (Group I) and 43 (mean age 28 years) were drug addicts (Group II). Underlying conditions other than drug abuse were noted in 74 patients in Group I and in only 7 in Group II.S. aureus was isolated from 117 patients and S. epidermidis in 6, all of them in Group I. 91 strains were penicillinase producers, but all susceptible to isoxazolyl-penicillins. In Group I verified or highly suspected endocarditis was registered in 12 patients (15%), always left-sided, as against in 31 (72%) in Group II, of whom 25 had tricuspid valve engagement. In the multivariate pattern of antibiotic treatment 3 groups may be discerned; 1) Cloxacillin, alone (35 patients) or in a combination (57), 2) Penicillin G, alone (6) or in a combination (12), and 3) Lincomycin or clindamycin, a cephalosporin or co-trimoxazole, alone (4) or in combination (9). Additive agents were mostly an aminoglycoside or fusidic acid. Out of the 45 patients in the whole material who received single therapy 9 patients (20%) died, and out of the 78 patients who received combined therapy 13 patients (16.6%) died. In the cloxacillin group 11.8% died, compared to 35% who initially received other antibiotics. In 70 patients the initial therapy had to be changed, in 39 due to adverse drug reactions and in 31 due to therapeutic failures or for unexplained reasons. In these cases linco- or clindamycin, more rarely rifampicin or vancomycin, were used. In Group I, 20 patients (25%) died, 8 of them with endocarditis. Sequels, relapses or reinfections were noted in 21 (25%), and 39 (50%) had an uneventful course. In Group II, 2 patients (5%) died, both with endocarditis. Sequels, relapses or reinfections occurred in 11 (25%), and 30 (70%) had an uneventful course. From this unstructured material no definite conclusions can be drawn. However, the lower mortality rate in the cloxacillin group suggests this regimen to be superior. The addition of other antibiotics did not appear to influence the clinical outcome. There was a more favourable outcome in addicts than in non-addicts, despite the same general principles of antibiotic treatment. Thus, for the outcome the characteristics of the patient group seemed to have more influence than the choice of antibiotic treatment.

Adolescent↗
PubMed1978

[Clinical and bacteriological studies on infections due to Acinetobacter calco aceticus (author's transl)].

The present studies concern with clinical backgrounds of the patients from whom Ac. calcoaceticus was isolated at the Juntendo University Hospital from Oct. 1976 until May 1977, and in-vitro observations on the susceptibility to antibiotics and chemotherapeutic agents of the organisms isolated from various clinical specimens from Sept. 1976 to May 1977. One hundred and eight strains of Ac. calcoaceticus were isolated from various clinical specimens of 78 patients. Approximately 70% of them was isolated from respiratory tract, and 6 approximately 8% from urinary tract, wound or bile. Ninety six of 108 strains were isolated in combination with other organisms. In retrospective view of 35 patients, all of them had one or more underlying diseases or predisposing factors, e.g., chronic disease, malignancy, infection due to other organism, surgery. Antibiotics had been administrated to 26 patients before onset of their infection with Ac. calcoaceticus. According to in-vitro susceptibility testing, the most active antimicrobial agents were minocyline and doxycycline. Gentamicin, tetracycline, kanamycin, amikacin, dibekacin, colistin, erythromycin, naladixic acid were given in this order. Most strains were resistant to ampicillin, sulbenicillin, cephaloridine, cefazokin, chloramphenicol, lincomycin, clindamycin, pipemidic acid and piperamic acid.

Acinetobacter↗
PubMed1983

Report on an intrafamiliar outbreak of Campylobacter enteritis.

An intrafamiliar campylobacter enteritis outbreak is described. From stools of three adults and two children, 5 Campylobacter jejuni strains resistant to erythromycin, lincomycin, and tetracycline, were isolated. From the sixth member of the family, a boy, a susceptible strain was isolated. Serological responses, measured using a serum bactericidal assay, against autologous and heterologous campylobacters have shown that one strain only, the resistant one, caused the outbreak. The source of infection was unknown.

Campylobacter Infections↗
PubMedDate not supplied

Antimicrobial susceptibility of Bifidobacterium.

The susceptibility pattern of 459 strains of bifidobacteria, representing 15 species, to 16 antimicrobial agents was determined by the broth dilution method. The majority of the strains derived from human faeces. Penicillin G, erythromycin, clindamycin, vancomycin and bacitracin were the most active compounds; they inhibited 90% of the strains at less than 1.6 micrograms/ml. All strains were susceptible to chloramphenicol (MIC90 = 2.0-5.8 micrograms/ml) and also to lincomycin (MIC50 = 0.64-1.5 micrograms/ml). Neomycin, streptomycin and tetracycline presented a great variability in their activity. Most strains were resistant to polymyxin B, nalidixic acid, kanamycin, gentamicin and metronidazole. The only variation in susceptibility which was observed among the different species concerned Bifidobacterium suis, which generally appeared to be more resistant than other species.

Actinomycetaceae↗
PubMed1983

[Surface-active properties of antibiotics].

The critical concentrations of the mycella formation of novobiocin, mithramycin, variamycin, erythromycin, oleandomycin and lincomycin were determined with two methods by changes in the isotherms of the surface tension and in the maximum absorption of rodamine due to the antibiotic concentrations. The results obtained with the two methods were comparable.

Adsorption↗
PubMedDate not supplied

Evaluation and use of a micro-broth dilution procedure for testing sensitivity of fermentative avian mycoplasmas to antibiotics.

A micro-broth dilution procedure is described for testing the sensitivity of glucose-fermenting avian mycoplasmas to antibiotics. A systematic evaluation was made of potential sources of variation that could affect the reliability of this procedure. Strain WVU 1853 of Mycoplasma synoviae (MS) was used as a standard culture and was tested against the antibiotics erythromycin, spiramycin, streptomycin, tetracycline, tiamulin, and tylosin. Inoculum density, duration of incubation before the test was read, and initial pH of the medium significantly affected test results. Type of serum and concentration of pig serum in the medium had little effect, provided the test was read when the phenol red indicator in the medium of a culture control (without antibiotic) had changed from deep red (pH 7.8) to orange-yellow (pH 7). The presence of bacterial inhibitors in the medium, the solvents used to dissolve some antibiotics, the use of thawed or actively growing cultures, and the number of passages of the culture before testing did not appear to be significant causes of test variation. By controlling important sources of variation, a standardized test was developed that gave reproducible results. The standardized test was used to determine the sensitivity to antibiotics of 49 strains of M. gallisepticum (MG), eight strains of MS, five strains of M. pullorum, seven strains of M. gallinaceum, and one strain of M. columborale. Minimum inhibitory concentrations of the macrolide antibiotics were lower for the majority of MG strains than for the other Mycoplasma species tested. However, some strains of MG showed acquired resistance to the macrolide antibiotics. These strains also showed increased resistance to lincomycin and tiamulin.

Animals↗
PubMedDate not supplied

Mycoplasma hominis infection of the central nervous system in newborn infants.

The incidence of infections of the central nervous system caused by Mycoplasma hominis in newborn infants is not known. However, such infections occur in both full-term and premature infants, either with or without malformations such as myelomeningocele. M. hominis has also been recovered from brain abscesses. Infected infants usually present with signs of meningitis or meningoencephalitis. Hydrocephalus may develop. The cerebrospinal fluid characteristically has a reduced glucose content and an elevated protein concentration. The white blood cell count is high, with a predominance of either mono- or polymorphonuclear leukocytes. Cerebrospinal fluid yields M. hominis but not other bacteria. Some newborn infants with M. hominis infection of the central nervous system die, whereas others survive and become healthy. In spite of adequate antibiotic therapy, some of those infected develop sequelae such as hemiplegia. Therapy with tetracycline or lincomycin can rapidly eradicate the organism from cerebrospinal fluid.

Antibodies, Bacterial↗