PubMed Health⌕ Search

Biomedical subjects

C D Ericsson

Publications and source records attributed to C D Ericsson.

At least 73 records · Page 4Linked to original sources
PubMed1986

Lack of emergence of resistant fecal flora during successful prophylaxis of traveler's diarrhea with norfloxacin.

Norfloxacin, a new quinolone carboxylic acid derivative, was compared with an identical-appearing placebo preparation in a prospective, randomized, double-blind trial for prevention of traveler's diarrhea among 120 U.S. students arriving in Mexico. Prophylaxis was continued for 2 weeks. Diarrhea was defined as four unformed stools in 24 h plus an additional symptom of enteric disease. In the norfloxacin prophylaxis group, 4 of 56 subjects (7%) experienced diarrhea, compared with 36 of 59 subjects (61%) in the placebo group. The difference was significant (P less than 0.0001). In contrast to our previous experience with use of trimethoprim-sulfamethoxazole to prevent traveler's diarrhea, quantitative stool cultures in the norfloxacin-treated group revealed a significant decline of normal aerobic fecal flora during prophylaxis (P less than 0.0005). Among stool samples from norfloxacin-treated subjects, 32 of 38 (84%) cultured on day 7 and 34 of 37 (92%) cultured on day 14 had no gram-negative bacilli. After norfloxacin was discontinued, fecal flora returned to pretreatment levels. No gram-negative aerobic flora resistant to norfloxacin were found during weekly quantitative cultures before, during, or after therapy.

Bacteria↗
PubMed1986

Emporiatric enteritis: lessons learned from U.S. students in Mexico.

In the studies reported, evidence has been presented that U.S. students traveling to Mexico represent a model for the study of travelers' diarrhea. The incidence of illness acquisition approximates that published in other studies of travelers. Natural immunity was shown to develop as students remained in Mexico presumably through repeated exposure to prevalent agents, particularly ETEC. ETEC, shigella strains and no detectable agent represented the largest groups when etiologic assessment was made. Food probably served as the important source of diarrhea particularly that due to ETEC and shigella strains. The level of bacteria isolated from food suggested that organism replication occurred due to improper temperature storage rather than to heavy initial contamination. The location of food consumption was related to degree of risk: self preparation was the safest, eating in Mexican homes the least safe and consumption of food in public restaurants was intermediate in risk. Water probably played a role in the transmission of viral infection. The risk of water contamination appeared to be highest during the rainy seasons. Finally, the antimicrobial agents TMP/SMX and TMP alone were shown to effectively prevent and treat this form of travelers' diarrhea.

Diarrhea↗
PubMed1985

Efficacy of bicozamycin in preventing traveler's diarrhea.

Bicozamycin was compared with a placebo in a prospective, randomized, double-blind study of the prevention of acute diarrhea among 30 American travelers newly arrived in Guadalajara, Mexico. None of the 11 subjects given bicozamycin orally for 3 wk at a dosage of 500 mg four times a day developed diarrhea as compared with an incidence of 53% diarrhea (10 of 19 subjects) in the placebo group (p = 0.003). Bicozamycin was well tolerated. Studies of changes in predominant aerobic fecal flora among the 11 subjects treated with bicozamycin showed the appearance of only one highly resistant Citrobacter freundii at the end of 1 wk of therapy and only a total of six resistant isolates at the end of 3 wk. All resistant isolates failed to transfer this resistance to a recipient Escherichia coli. Bicozamycin seems to be well suited and safe as a prophylactic agent against traveler's diarrhea.

Acute Disease↗
PubMed1985

A newly recognized cause of travelers' diarrhea: enteroadherent Escherichia coli.

Adherence to HEp-2 tissue culture cells has been proposed as a virulence characteristic of enteropathogenic Escherichia coli (EPEC). A preliminary study revealed that E. coli that adhered to HEp-2 cells, but did not produce conventional enterotoxins and did not belong to recognized EPEC serogroups, could be isolated from adults from the United States who acquired diarrhea in Mexico. The purpose of this study was to determine the prevalence of these enteroadherent E. coli (EAEC) in 188 travelers with diarrhea and in 92 well travelers. EAEC were found in 14.9% of patients with diarrhea and in 7.6% of well individuals. Compared with well travelers, patients with diarrhea in whom no recognized enteropathogen could be identified had a 30.4% prevalence of EAEC (P less than .0003). These results further support our finding that EAEC are associated with diarrhea in travelers to Mexico and may help to explain the effect of antibiotics in the prevention and therapy for travelers' diarrhea in patients with no recognized bacterial enteropathogens.

Adhesiveness↗
PubMed1984

Comparative bioavailability of intravenous and oral chloramphenicol in adults.

The comparative bioavailability of chloramphenicol from intravenous succinate, oral palmitate, and oral base preparations was studied in a crossover manner in 12 adult patients. Chloramphenicol was administered at a dose of 1 Gm every 6 hours, and blood samples were collected at steady state. For the succinate study, total urine output was also collected. The bioavailability of active chloramphenicol from the succinate preparation averaged 85.8 +/- 42.3 and 78.8 +/- 50.1 per cent of the free base and palmitate forms, respectively. This lower availability appeared to be due to variable excretion of unchanged succinate in the urine, averaging 27 +/- 11 per cent of the dose. Regardless of dosage form or route of administration, plasma chloramphenicol concentrations remained in the therapeutic range (5 to 25 mg/liter) for the entire dosage interval, implying that no change needs to be made when changing dosage form or route of administration. The interpatient variability, however, supports the need for monitoring of plasma chloramphenicol concentrations, especially in newborn infants, persons with liver disease, or those receiving other medications that alter chloramphenicol metabolism.

Administration, Oral↗
PubMed1984

Comparative studies of antibiotic therapy after penetrating abdominal trauma.

Two prospective, randomized trials of the efficacy of antibiotic regimens after penetrating abdominal trauma demonstrated that a combination of clindamycin and tobramycin was superior to cefamandole or cefoxitin in preventing postinjury wound infection but that no difference could be demonstrated between combination therapy (clindamycin plus tobramycin) and moxalactam. Infection was more likely to occur after a gunshot wound or with a high injury severity score and occurred after the 10th postinjury day only in those patients who received cefamandole or cefoxitin. There was a higher incidence of culture of B. fragilis in the latter groups as well as infections due to resistant organisms. Short-term antibiotic therapy for 72 hours with either tobramycin plus clindamycin or moxalactam appears adequate for the majority of patients after gunshot or knife wounds. The costs of these regimens to the patient were similar in our hospital. The most important single factor, however, in maintaining low infection rates after penetrating injury to the abdominal cavity is appropriate and timely surgical management.

Abdominal Injuries↗
PubMed1984

Furazolidone versus ampicillin in the treatment of traveler's diarrhea.

Ninety-four U.S. students who acquired diarrhea in Mexico were treated with furazolidone (47 subjects) or ampicillin (47 subjects) on a double-blind random basis. Of 47 students, 26 (55%) who received furazolidone (100 mg four times daily for 5 days) recovered from illness within 48 h after initiation of therapy, in contrast to 15 of 47 (32%) who received ampicillin (500 mg four times daily for 5 days) (P less than 0.05). Altogether, 74% of students treated with furazolidone and 49% of those receiving ampicillin were well within 72 h (P less than 0.05). When furazolidone was compared with ampicillin, clinical illness was shortened on the average from 65 to 61 h for enterotoxigenic Escherichia coli diarrhea, from 83 to 58 h for shigellosis, from 82 to 51 h for diarrhea unassociated with a detectable agent, and from 72 to 57 h for all cases irrespective of etiology. Although not dramatically effective in the current trial, the broad spectrum of activity of furazolidone is of interest. Because of in vitro activity against Campylobacter strains and known effectiveness in treating giardiasis, furazolidone should be considered in therapy for diarrhea of unknown etiology in certain settings when laboratory processing of stools for etiological agent is not feasible.

Ampicillin↗
PubMed1983

Bacteriological studies of the enteric flora of patients treated with bicozamycin (CGP 3543/E) for acute nonparasitic diarrhea.

During a therapeutic trial of bicozamycin (BI) for traveler's diarrhea, aerobically grown, gram-negative bacteria, predominantly Escherichia coli, were decreased by 2 to 3 logs per g of stool; the number of BI-resistant gram-negative bacteria did not increase. Resistant species were most often Citrobacter freundii, Klebsiella pneumoniae, and Morganella morganii, and few BI-resistant E. coli strains were isolated. Cross-resistance between BI and other antimicrobial agents was not found. Resistance to BI could not be transferred or mobilized to an E. coli K-12 recipient.

Acute Disease↗
PubMed1983

Incidence of bacterial enteropathogens in foods from Mexico.

We examined food consumption patterns of U.S. students temporarily living in Guadalajara, Mexico. Consumption of foods prepared in Mexican homes was associated with an increased risk of acquisition of diarrhea. Foods from commercial sources and private Mexican homes in Guadalajara were subsequently examined for contamination with coliforms, fecal coliforms, and bacterial enteropathogens. For comparison, selected restaurant foods were obtained in Houston, Tex. Food obtained from Mexican homes showed generally higher counts of coliforms and fecal coliforms than those obtained from commercial sources in Mexico and Houston. The foods in Mexico, both from homes and commercial sources, commonly contained Escherichia coli and occasionally enterotoxigenic E. coli. Foods in Houston were not contaminated with E. coli or enterotoxigenic E. coli. Salmonella (17 isolates), Shigella (4 isolates), and Aeromonas hydrophila (1 isolate) were found only in the foods obtained from Mexican homes. Enterotoxigenic non-E. coli Enterobacteriaceae was recovered with approximately equal frequency from all food sources.

Diarrhea↗
PubMed1983

Comparison of methods to detect Escherichia coli heat-labile enterotoxin in stool and cell-free culture supernatants.

We compared the standard Y-1 adrenal cell (YAC) assay for heat-labile enterotoxin (LT) with newer rapid and economical immunological methods of detection. Stool samples were collected from 164 acutely ill American students in Guadalajara, Mexico. Supernatants were prepared from each stool. Stools were cultured for Escherichia coli by standard techniques. Individual E. coli-like colonies were examined for LT production by the Biken assay. Culture supernatants and stool supernatants were assayed for the presence of LT by the YAC assay, counterimmunoelectrophoresis, and enzyme-linked immunosorbent assay (ELISA). Standard YAC assays of culture supernatants revealed that 40 of the 164 specimens (24%) were LT positive. Counterimmunoelectrophoresis detected 60% and ELISA detected 65% of the 40 known positives when culture supernatants were used. The Biken assay detected 35% of the 40 known positives. With stool supernatants, the YAC assay detected only 18% of the known positives, counterimmunoelectrophoresis detected 60%, and ELISA detected 90%. In addition, ELISA detected 13 LT-positive stool supernatants not detected by the YAC assay of culture supernatants. The ELISA in which stool supernatants are used may be a useful method to detect LT.

Acute Disease↗
PubMed1983

Bicozamycin, a poorly absorbable antibiotic, effectively treats travelers' diarrhea.

The efficacy of bicozamycin, a poorly absorbable antibiotic, in the treatment of acute diarrhea was assessed in a prospective, double-blind study of 140 adults from the United States visiting Guadalajara, Mexico. Patients randomly received bicozamycin (500 mg orally four times daily) or placebo for 3 days. The mean duration of illness was shorter in the bicozamycin than the placebo treatment groups for patients with diarrhea due to Shigella (37 versus 96 hours; p = 0.01), toxigenic Escherichia coli (31 versus 60 hours; p = 0.003), and unknown pathogens (18 versus 41 hours; p = 0.02). Cramps were significantly relieved by bicozamycin in all patients. Treatment failed in significantly fewer patients treated with bicozamycin than those treated with placebo when diarrhea was associated with Shigella, Salmonella or toxigenic E. coli. Bicozamycin was well tolerated and appears to be effective therapy for acute travelers' diarrhea of diverse causes. These data show the value of an antibiotic in the therapy of toxigenic E. coli infection and indicate a need to reevaluate the clinical dictum that nonabsorbable antibiotics are ineffective against invasive enteropathogens.

Absorption↗
PubMed1983

Antimicrobial therapy of travellers' diarrhoea.

Two trials were carried out to evaluate antimicrobial agents in the therapy of travellers' diarrhoea. In the first, 72 students were given 500 mg bicozamycin (BI), a poorly absorbable drug, q.i.d. for three days and 68 were given a placebo. In the second, 37 students were given trimethoprim/sulphamethoxazole (160 mg TMP-SMX 800 mg), 38 TMP (200 mg), and in 35 a placebo was given b.i.d. for five days. Diarrhoea lasted on average 28 hours in those receiving BI compared to 64 hours in the placebo group (p = 0.00009). Significant shortening of diarrhoea after taking BI was seen for all subjects with illness, as well as those with ETEC diarrhoea, shigellosis and for those with unknown causes of illness. A significant clinical response was also noted in all categories of diarrhoea for both TMP-SMX and TMP when compared to placebo group.

Anti-Infective Agents↗
PubMed1982

Influence of subsalicylate bismuth on absorption of doxycycline.

The influence of a typical 60-mL dose of subsalicylate bismuth (Pepto-Bismol) on the absorption of 200 mg of orally administered doxycycline hyclate was studied. Bioavailability of doxycycline was significantly reduced by 37% and 51%, respectively, when subsalicylate bismuth was given simultaneously and as a multiple-dose regimen before doxycycline. Peak serum concentrations of doxycycline were significantly decreased when subsalicylate bismuth was given two hours before doxycycline but not when given two hours after doxycycline. Subsalicylate bismuth should not be taken when doxycycline is used for therapeutic purposes, and we suggest travelers should not take the agents together in an effort to prevent diarrhea.

Adult↗