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Biomedical subjects

D F Busch

Publications and source records attributed to D F Busch.

12 recordsLinked to original sources
PubMed1991

Prevalence of resistance in patients receiving ganciclovir for serious cytomegalovirus infection.

Seventy-two AIDS patients treated with ganciclovir for cytomegalovirus (CMV) disease were prospectively monitored for the development of drug-resistant virus. No resistant strains were found in 31 patients before therapy or among seven culture-positive patients treated for less than or equal to 3 months. Of 13 culture-positive patients treated for greater than or equal to 3 months, 5 excreted virus resistant (ED50, greater than 12 microM, or ED90, greater than 30 microM) to ganciclovir. Thus, 38% of patients and receiving ganciclovir for greater than 3 months and excreting virus or, overall, 7.6% of the patients were excreting CMV resistant to the drug.

Acquired Immunodeficiency Syndrome↗
PubMed1978

Anaerobic and aerobic bacteriology in head and neck cancer surgery.

A prospective study of wound infections following major head and neck cancer surgery was undertaken to define a rational approach to trials of antibiotic prophylaxis and initial therapy of these infections. Preoperative aerobic cultures were taken from the planned site of skin incision and from the oropharynx. Both aerobic and anaerobic cultures were obtained from all wound infections. Patients receiving prophylactic antibiotics were excluded from the study. The data indicate that preoperative cultures are not usually predictive of the bacteriology of subsequent wound infection. Mixed aerobic and anaerobic flora were cultured from most wound infections and usually reflected normal anaerobic oropharyngeal flora and/or exogenously acquired Staphylococcus aureus. Bacteroides fragilis was not cultured in this series. Antibiotics selected for trials of prophylaxis or initial treatment of these infections should cover both the resident oral aerobic and anaerobic flora and S aureus. Coverage for B fragilis does not appear necessary. Antibiotic choices might include (1) penicillin G agents plus a penicillinase-resistant penicillin or (2) a parenteral cephalosporin.

Head and Neck Neoplasms↗
PubMed1978

An acquired cell-directed inhibitor of neutrophil chemotaxis and hypogammaglobulinemia.

An unusual combination of host defense abnormalities was demonstrated in an adult male with recurrent pulmonary infections due to a variety of microorganisms. Polymorphonuclear neutrophil chemotaxis was defective. Other neutrophil and T-lymphocyte function tests were normal. The patient's serum also showed a severe deficiency of IgG, no detectable IgA, IgM, or IgD, and increased IgE. The chemotactic defect was shown to be due to a cell-directed inhibitor in the patient's serum. The effect of the inhibitor on chemotaxis could be antagonized by factors in normal serum. The chemotaxis defect persisted for several months, but eventually returned to normal.

Adult↗
PubMed1978

Group G streptococcal endocarditis.

The group G streptococcus may be a more common human pathogen than previously recognized. A case of group G streptococcal endocarditis is reported and the 11 cases reported previously are reviewed. Group G endocarditis may have significant clinical and prognostic differences from endocarditis caused by the more commonly identified viridans or group D streptococci. Routine serologic grouping of beta-hemolytic streptococcal isolates from serious infections is warranted.

Diagnosis, Differential↗
PubMed1977

Doxycycline in abdominal surgery.

Twenty patients undergoing urgent or emergency surgical procedures where intra-abdominal infection was suspected were treated with doxycycline hyclate. Wound infections involving anaerobic, aerobic, or facultative bacteria developed in four of 11 patients treated with doxycycline alone. Nine other patients received higher doses of doxycycline plus gentamicin sulfate. Five of these had postoperative infections primarily involving anaerobic organisms. Bacteremia with a doxycycline-resistant Bacteroides fragilis developed in one patient during therapy. Serum levels of doxycycline, even at the higher dosage, were below the minimal inhibitory concentrations (MICs) of a number of potential pathogens isolated at the time of surgery. Doxycycline is not indicated in cases of serious intra-abdominal infection unless the infecting flora are known to be susceptible.

Abdomen↗
PubMed1977

Cefoxitin: clinical evaluation in thirty-eight patients.

Clinical and bacteriological efficacy, patient tolerance, and toxicity of cefoxitin, a beta-lactamase-resistant cephamycin, were evaluated in 38 patients; 13 had soft tissue infection, 12 had pneumonia, 3 had urinary tract infection, 2 had peritonitis, and 4 had miscellaneous infections. In five patients, infection was clinically evident, though not bacteriologically proven. The latter patients were evaluated with regard to tolerance and toxicity only. Among the 34 infections in 33 patients, 71% were considered clinically cured; 86% of those patients who could be recultured were bacteriologically cured. Phlebitis was noted in 32% of the total group, and eosinophilia was observed in 16%. Unexplained deterioration in renal function occurred in two patients. Mean peak cefoxitin levels in serum were 72 mug/ml 30 min after a 2-g infusion and 32 mug/ml 30 min after a 1-g infusion. Cefoxitin was more active against facultatively and obligately anaerobic gram-negative organisms isolated from these patients than was cephalothin.

Adult↗
PubMed1976

Activity of combinations of antimicrobial agents against Bacteroides fragilis.

Thirty-two clinical isolates of Bacteroides fragilis were tested against nine pairs of antimicrobial agents by means of an agar dilution technique. A synergistic effect was observed with the combination of clindamycin and metronidazole. End points were achieved with 17 strains. Of these strains, 13 (76%) were inhibited by the combination of clindamycin and metronidazole; each drug was present at a concentration of less than or equal to 25% of its minimal inhibitory concentration when tested alone. This combination also showed synergistic bactericidal activity against three of six strains examined by a tube dilution technique. No antagonism was noted with any strain. The other eight combinations tested failed to show a consistent synergistic effect, although no antagonism was observed. These in vitro data indicate that antagonism is not likely to be encountered when combination therapy is used for B. fragilis infections. For selected B. fragilis infections, the combination of clindamycin and metronidazole may be useful.

Amikacin↗
PubMed1976

Susceptibility of respiratory tract anaerobes to orally administered penicillins and cephalosporins.

Anaerobic bacteria recovered from airway-related infections were tested by agar dilution against selected penicillins and cephalosporins available for oral administration. Against 136 isolates, penicillins G and V showed comparable activity, particularly when pharmacological differences were considered. Although many isolates were exquisitely susceptible to the penicillins, only 55% of the Bacteroides species and 72% of all isolates were inhibited at 0.5 mug of penicillin G per ml. Results for penicillin V at 1 mug/ml were similar (59 and 73%). The two cephalosporins were more active at achievable levels, inhibiting 94 to 95% of Bacteroides and 95 to 96% of all isolates at 8 mug/ml. These levels represent approximately 50% of the reported peak serum levels after oral administration of 625 mg of the penicillins and 500 mg of the cephalosporins. Dicloxacillin and nafcillin were tested against 50 isolates. The two were comparably active on a weight basis; dicloxacillin was more active when pharmacological differences were considered, but did not match the other penicillins or the cephalosporins.

Anaerobiosis↗
PubMedDate not supplied

Cefoxitin for treatment of infections due to anaerobic bacteria.

Twenty-seven patients with 29 infections due to anaerobic or mixed anaerobic-aerobic bacteria were treated with cefoxitin. From the 27 patients 99 isolates of anaerobic bacteria and 70 isolates of aerobic bacteria were recovered. Twelve pleuropulmonary infections, 12 soft tissue infections, three bone infections, and two intraabdominal infections were treated. Twenty-six of the 29 infections were completely or partially eradicated; the remaining three infections were unchanged. One-third of the patients experienced phlebitis; in two instances severe phlebitis caused discontinuation of therapy. In this study cefoxitin appeared to be an effective single agent for the therapy of infections due to specific anaerobic bacteria or to a mixed flora of anaerobic and aerobic bacteria.

Adult↗