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At least 19 recordsLinked to original sources
PubMed1979

Single-antibiotic therapy for streptococcal endocarditis.

Ninety-nine patients treated with penicillin G potassium, cephalothin sodium, or vancomycin hydrochloride were studied to evaluate single-drug therapy for nonenterococcal streptococcal endocarditis. Eighty-six patients survived; of these, 66 received penicillin alone. The maximum serum bactericidal titer obtained at the expected nadir of serum antibiotic concentration was 1:8 or greater in 70 (95%) of the 74 patients studied. No relapse occurred among the 66 patients treated wih penicillin. Only one patient experienced a relapse that occurred following therapy with suboptimal doses of vancomycin. Distinct second episodes of endocarditis occurred in five patients. While 13 patients died, none died of intractable infection. The treatment of endocarditis due to penicillin-susceptible streptococci with high-dose parenteral penicillin or a bactericidal penicillin substitute for four weeks or longer results in bacteriologic cure rates comparable with those achieved with combined penicillin-streptomycin regimens.

Administration, Oral↗
PubMedDate not supplied

Beta-lactam antibiotics alone or in combination with gentamicin for therapy of gram-negative bacillary infections in neutropenic patients.

This study was initiated to determine whether antibiotic combinations are superior to single antibiotics for the treatment of gram-negative bacillary infections in neutropenic patients. Twenty-six patients with Pseudomonas and Proteus infections received either carbenicillin or carbenicillin, plus gentamicin. The cure rates were 83 and 93 per cent, respectively. Twenty-three patients with infections caused by other gram-negative bacilli received either cephalothin plus gentamicin. The cure rates were 64 and 67 per cent, respectively. Superinfection occurred in 26 per cent of the patients who received a single antibiotic compared to 15 per cent of the patients who received a combination. Four of the 26 patients who received gentamicin developed transient azotemia. Combination therapy may be superior to single antibiotic therapy, but this study demonstrated no statistically significant differences.

Adolescent↗
PubMed1977

Single-dose antibiotic prophylaxis in appendectomy.

Prophylactic antibiotics will reduce the number of wound infections after so-called clean-contaminated gastrointestinal operations. The prophylactic regimen must be designed with the pharmacokinetical properties of the used drug, in mind. A safe and simple, easily standardized procedure, applicable in both elective and acute clinical situations is preferable. A single-dose regimen with prophylactic cephaloridine has been tried and evaluated.

Appendectomy↗
PubMed1977

Treatment of Mycoplasma hyorrhinis contaminated tissue cultures with a mixture of antibiotics.

Results obtained using a combination of antibiotics to control mycoplasmas in tissue cultures are described. Cell strains and established cell lines from several mammalian species grown in tissue culture were found to be highly contaminated with M. hyorrhinis. Cultures were treated with a mixture of three antibiotics consisting of gentamicin, tetracycline and chloramphenicol, and since that time tests for mycoplasmas in the treated cultures have consistenly yielded negative results. Apart from a transient cytostatic effect on the cells during the treatment, no apparent unwanted effects were observed. The mixture of three antibiotics appeared to be superior to treatment with antibiotics singly or combinations of two antibiotics.

Animals↗
PubMed1975

[Theoretically probable assessment of the effectiveness of individualized combined antibiotic therapy of patients with suppurative inflammatory processes].

Efficiency of individual combined antibiotic therapy of patients was estimated in comparison to the use of single antibiotics of their fixed combinations without any special control group. Since the essence of the study was practically in successive appliance of the 2 methods of therapy to the same group of the patients, it was possible to carry out theoretically probable estimation of the final result as a summation effect of both methods and to define the probable result of the 2 nd method. The study of the results of the treatment of the patients with purulent-inflammatory processes showed significant advantages of the individual combined antibiotic therapy.

Animals↗
PubMed1976

Single-dose peroperative antibiotic prophylaxis in gastrointestinal surgery.

A single intravenous dose of tobramycin and lincomycin, given at the start of gastrointestinal operations, significantly reduced the incidence of postoperative wound infection from 34% to 5%. The occurrence of both anaerobic and aerobic bacteria was reduced. Therapeutic concentrations of the antibiotics were maintained throughout the operative period in most cases. No toxic effects of the antibiotics were detected, no anaesthetic complication occurred, and resistant strains of bacteria normally sensitive to the antibiotics were not isolated from wounds.

Adolescent↗
PubMed1979

Evaluation of gentamicin and penicillin as a synergistic combination in experimental murine listeriosis.

The administration of a combination of penicillin and gentamicin to mice given an intraperitoneal challenge of a highly pathogenic strain of Listeria monocytogenes resulted in increased survival as compared with groups receiving penicillin alone or gentamicin alone or a control group that received no antibiotic. The median survival of animals that eventually died was no longer than in groups receiving single antibiotics and suggests that additional studies should be carried out to further investigate the possibility of synergism in animal models.

Animals↗
PubMed1979

Susceptibility and synergy studies of methicillin-resistant Staphylococcus epidermidis.

Methicillin-resistant Staphylococcus epidermidis is an important cause of cerebrospinal fluid shunt infections and prosthetic valve endocarditis. Agar dilution minimum inhibitory concentrations were determined for 100 strains of methicillin-resistant S. epidermidis which were isolated from clinical specimens. Vancomycin inhibited all 100 strains at </=3.12 mug/ml, whereas clindamycin inhibited only 46 strains at </=12.5 mug/ml. Methicillin-resistant S. epidermidis strains were resistant to achievable levels of erythromycin, with 90 strains having a minimum inhibitory concentration of >/=3.12 mug/ml. Of the five cephalosporins and one cephamycin tested, cefamandole was the most active in vitro, inhibiting 97 strains at </=25 mug/ml. Antibiotic synergism was examined by a quantitative bacterial time-kill method. Synergism (>/=10(2) kill by the combination over the most effective single antibiotic at 24 h) was demonstrated with vancomycin (1.56 mug/ml) plus cefamandole (6.25 mug/ml) in 14 of 14 strains, vancomycin plus cephalothin (6.25 mug/ml) in 14 of 14 strains, vancomycin plus rifampin (0.008 to 0.012 mug/ml) in 6 of 12 strains, rifampin plus cefamandole in 9 of 12 strains, and rifampin plus cephalothin in 10 of 12 strains. The emergence of populations of bacteria resistant to 0.2 mug of rifampin per ml developed in three of five methicillin-resistant S. epidermidis strains tested. The addition of either vancomycin, cephalothin, or cefamandole to the rifampin prevented the emergence of resistance in these three strains. Clinical trials of synergistic antibiotic combination therapy for serious methicillin-resistant S. epidermidis infections are indicated.

Anti-Bacterial Agents↗
PubMed1979

Principles and practice of antibiotic therapy for post-traumatic abdominal injuries.

Improved surgical techniques, the use of modern antibiotics and better understanding of the microbiologic characteristics of abdominal sepsis have lead to a satisfying clinical outcome in instances of abdominal trauma which once meant almost certain death. Yet many questions remain unanswered. Future development of several newer antibiotics may further improve the rate of complications. A study of host defense mechanisms may provide additional clues to prevent long term morbidity. Hopefully, future studies will encourage the use of a single antibiotic in the treatment of abdominal trauma. While the newer antibiotics are being investigated, certain older antibiotics, such as penicillin, chloramphenicol and tetracycline, merit additional evaluation under controlled, prospective, randomized, comparative clinical trials.

Abdomen↗
PubMed1977

[Rational use of antibiotics in digestive surgery].

The abusive and inappropriate use of antibiotics in digestive surgery has led to the selection of multi-resistant strains responsible for sometimes dramatic infective complications. The study of the normal digestive flora under pathological conditions, knowledge of the mechanisms of resistance, led us to propose the use of antibiotics with circumspection, depending on the germ isolated and the probable efficacy of the drugs. Prophylactic antibiotic therapy is only justified with regard to gram positive anaerobic bacteria or, in exceptional cases, where the risk seems high and may irremediably compromise the surgical procedure. Curative antibiotic therapy, after treatment of the infective focus, is often sufficient but depends on the bacteria: Whether anaerobic, staphylococci of Gram negative bacilli, with regard to which one should use narrow spectrum single antibiotics.

Anti-Bacterial Agents↗
PubMed1976

[Erythromycin penetration into the cerebrospinal fluid of patients].

Permeability of erythromycin through the barrier of blood-cerebrospinal fluid in neurosurgical patients after its oral administration in a dose of 300-500 mg and intravenous administration in a dose of 200 mg was studied. The erythromycin was determined after the antibiotic single administration at intervals of 40 minutes to 6 hours. A total of 31 observations were performed. Low penetration of erythromycin into the cerebrospinal fluid of the patients was shown. The administration route (oral or intravenous) practically had no effect on the antibiotic penetration level into the subarachnoidal spaces. The highest liquor levels were observed within the period of 3 to 6 hours after the drug administration. The maximum index of penetration from the blood into the cerebrospinal fluid was about 10 per cent. The erythromycin penetration increased in cases with inflammatory changes in the meninges.

Administration, Oral↗
PubMed1977

Plantar ulcers with osteomyelitis underneath. A bacteriological study.

39 consecutive cases of plantar ulcers with underlying chronic osteomyelitis admitted in the Sacred Heart Hospital during 1975/1976 were studied for the infecting organisms and their sensitivity to easily available antibiotics. Single organism was iasolated in only 10 cases, the infection in the rest being a mixed one. The commonest organisms were Staphylococcus, Streptococcus and Proteus mirabilis. In a few cases Pseudomonas and E-Coli were also isolated. Chloramphenicol was the most effective antibiotic in general and Streptomycin the least. 70% of the staphylococcus strains isolated were found to be resistant to Penicillin. Empirical use of antibiotics especially Penicillin and Streptomycin is hence deprecated.

Adolescent↗
PubMed1975

Relationship of early readings of minimal inhibitory concentrations to the results of overnight tests.

Broth dilution minimal inhibitory concentration (MIC) readings were compared after different incubation periods and with different inoculum concentrations. The purpose was to determine the best conditions for obtaining early results as close as possible to overnight readings. Initially, 76 antibiotic-organism combinations were tested using the International Collaborative Study technique and inoculum and were read after 3, 8, and 18 h of incubation. Approximately 28% of tests showed fourfold or greater increases in MICs after 18 h of incubation compared with the 3-h readings. No overnight MICs were lower than early readings. MICs of single antibiotics against seven organisms were also read with an automatic particle counter to confirm the validity of the visual readings. Experiments were made to determine whether inoculum manipulation could reconcile the differences between 3- and 18-h MIC results. One hundred and eight organism-antibiotic combinations were tested comparing 3-h MIC readings using an inoculum of 10(7) organisms per ml with overnight readings using 10(5) per ml. In 71 cases, readings with both inocula were within the range tested and 57 (86%) were within +/-1 log(2) of each other and followed an approximately normal distribution. Improved comparability between early read and overnight MICs thus may be achieved by inoculum manipulation, and this may be a suitable approach in the future development of automated procedures.

Anti-Bacterial Agents↗
PubMedDate not supplied

Prognostic factors in Staphylococcus aureus endocarditis and results of therapy with a penicillin and gentamicin.

Data on 40 patients with Staphylococcus aureus endocarditis treated with appropriate antibiotics in adequate dosage at the University of Cincinnati Medical Center hospitals between January 1961 and June 1975 were analyzed. The overall mortality was 40 per cent. The mortality was 11.1 per cent in patients under 50 years old and 63.6 per cent in patients over 50 years old (p less than 0.01). Seven patients were narcotic addicts who had no underlying disease and were under 50 years old; all survived. For patients without underlying diseases, the mortality was 0 per cent in those under 50 years old and 75 per cent in those over 50 years old. Patients who died had a greater number of major underlying diseases (pre-existing cardiac disease, diabetes mellitus, alcoholism and/or cirrhosis) than the survivors. Patients over 50 years old had significantly more major underlying diseases than patients under 50 years old (p less than 0.001). Among patients over 50 years old, those who died had more complications than the survivors while the number of underlying diseases were comparable. A group of patients treated with gentamicin during the first two to three weeks of therapy in addition to a penicillin was compared to a similar group treated with a single antibiotic. The mortality of both groups was 40 per cent.

Adolescent↗
PubMed1976

Urinary tract infections in children and adolescents.

Recent advances in the understanding of urinary tract anatomy, function, and disease should lead to a reassessment of the clinical approach to urinary tract infection. Many traditional concepts must be seriously questioned in light of new information. These include the belief that pyuria or "typical" signs and symtoms are diagnostic. Diagnosis depends on detection of persistent bacteriuria by careful screening and culture of properly collected uring specimens. Once diagnosis is confirmed, oral administration of a single antibiotic for ten days is usually effective. Patients with suspected pyelonephritis or with recurrent or unresponsive urinary tract infection should be treated with two antibiotics. Success of treatment must always be confirmed by culture after discontinuance of therapy. In all cases, follow-up every one to two months should continue until the patients have remained free of infection for a period of one year. Refractory cases may require radiologic study and referral to a urologist.

Adolescent↗
PubMed1976

Synergism of cefazolin-gentamicin against enterococci.

A miniaturized technique for detecting antibiotic synergy by using microliter volumes was perfected. With this microtiter serial dilution method, the effect of the previously untried combination of cefazolin and gentamicin on 10 strains of enterococci was evaluated. At clinically achievable concentrations, the combination of cefazolin and gentamicin was found to be synergistic against all 10 strains when the data were plotted in the form of an isobologram. These results were compared with the conventional method of detecting synergy in vitro, namely, the determination of the rate of killing of the microorganisms with the antibiotics, singly and in combination. Similar results were also observed. These findings indicate that the microtiter serial dilution technique is a useful method for the routine determination of drug synergy. Moreover, in a patient with penicillin hypersensitivity and enterococcal infection, the combination of cefazolin and gentamicin should be considered for possible therapy.

Cefazolin↗
PubMed1978

The management of childhood osteomyelitis.

The management of seventy-six children admitted to Aler Hey Children's Hospital with osteomyelitis is discussed and the indications for surgical intervention are defined. The clinical and pathological course of the disease is examined and the term post-acute osteomyelitis is introduced. The importance of recognition of this stage of the disease and its relevance to the management is highlighted. The use of single antibiotic therapy (clindamycin) is shown to be at least as effective as combinational therapy. Complete resolution was achieved in 94.7% of children, surgical intervention was performed on 74.6%.

Adolescent↗