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Biomedical subjects

B L Ashby

Publications and source records attributed to B L Ashby.

3 recordsLinked to original sources

Gram-negative sepsis with acute renal failure. Occurrence from acute glomerulonephritis.

Acute intrinsic renal failure occurred in an adult patient with Escherichia coli septicemia. The clinical course did not include any of the circumstances usually present when acute renal failure complicates Gram-negative sepsis. A renal biopsy showed acute proliferative glomerulonephritis. There was no evidence to support other known causes of acute parenchymal renal failure, such as poststreptococcal glomerulonephritis, subacute bacterial endocarditis, or vasculitis. The patient recovered completely with antibiotic therapy, and renal function returned to normal within two weeks. An immunologic mechanism involving E coli was considered responsible for the acute renal failure.

Acute Disease

Treatment of pneumonia: new strategies for changing pathogens.

Changes in the etiologic agents that cause pneumonia pose new challenges for empiric antimicrobial therapy. Ofloxacin is a new oral quinolone antibiotic with good to excellent activity against many of the usual and atypical pulmonary pathogens. Clinical trials have demonstrated high clinical and microbiological cure rates with ofloxacin and comparable efficacy to standard antibiotics used to treat pneumonia. Compared with ciprofloxacin, ofloxacin provides greater bioavailability, extended inhibitory concentrations in the blood, similar activity against gram-negative pathogens, better activity against gram-positive bacteria, in vitro activity against atypical pathogens, renal elimination, and a lower potential for interactions with theophylline and caffeine. These advantages suggest that ofloxacin should be the first-choice quinolone when Staphylococcus aureus is suspected, when higher and prolonged serum and tissue concentrations are needed, and when the patient is also receiving theophylline. In addition, the substitution of a potent oral antibiotic such as ofloxacin for intravenous agents may enable some hospital patients to continue their therapy as outpatients, thus reducing health-care costs.

Adult