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Biomedical subjects

D S Reeves

Publications and source records attributed to D S Reeves.

At least 19 recordsLinked to original sources
PubMed1992

Treatment of bacteriuria in pregnancy with single dose fosfomycin trometamol: a review.

Bacteriuria in pregnancy occurs in about one in 20 pregnant women and is usually initially asymptomatic. It is an important marker for acute symptomatic infection (often pyelonephritis) later in pregnancy, which occurs in about one in four bacteriurics. Several considerations surround the antibiotic treatment of the asymptomatic infection; these include a low frequency of in vitro resistance to the agent used, lack of toxicity to the foetus, a low incidence of gastrointestinal side effects, good compliance and proven efficacy. Fosfomycin trometamol seems to fit these requirements. In three controlled studies (two multicentric) 250 patients were treated with fosfomycin trometamol in a 3 g (as fosfomycin) single dose; 197 patients were given one of three other agents. Cure rates for fosfomycin trometamol were 77-94% (68-94% for other agents), which was satisfactory in an infection which is sometimes difficult to eradicate. Further studies are needed in this important but accessible group of patients. Opportunities should be taken to study more foetal outcomes and provide more data on gastro-intestinal tolerability.

Bacteriuria↗
PubMed1992

Comparison of three methods of antibiotic prophylaxis in knee arthroplasty.

Prophylactic intravenous cefamandole nafate was administered by the systemic, systemic with probenecid (causing renal tubular blockade of antibiotic excretion), and intravenous regional routes. Bone antibiotic levels were assayed 15 minutes and 12 hours after administration, and hematoma concentrations after 8 hours. Bone concentrations after intravenous regional administration were significantly greater than systemic after 15 minutes, but were not detectable after 12 hours. Probenecid produced inhibitory concentrations in bone after 12 hours and also increased hematoma antibiotic concentrations to three times those achieved by systemic administration. Adequate prophylaxis may be possible with two rather than three doses of cefamandole if probenecid is used.

Cefamandole↗
PubMed1992

Pharmacokinetics and metabolism of FCE 22101 following its administration as the oral pro-drug FCE 22891.

Ten healthy male volunteers who had previously received both intramuscular and intravenous doses of FCE 22101 received a single oral dose of FCE 22891, the acetoxymethyl ester and pro-drug of FCE 22101. After a lag time of 22 min, mean plasma levels of FCE 22101 rose with a T1/2 absorbance of 19 min to 2.5 mg/L at 30 min, 3.6 mg/L at 60 min and a Cmax of 4.6 mg/L at 80 min; levels then fell with a T1/2 beta of 29 min to be undetectable at 300 min. The mean area under the concentration-time curve (AUC) was 497 mg.min/L giving an absolute bioavailability for FCE 22101 of 32%. Neither FCE 22101 or its metabolites were present in any of the saliva samples collected at intervals up to 360 min after dosing. Mean urinary recoveries were FCE 22101 12% (+/- S.D. 4.6), P1 16% (+/- S.D. 9.1) and P2 3.3% (+/- S.D. 2.1). It was not possible to detect the pro-drug FCE 22891 in any of the blood or urine samples. Significant levels of the metabolite P1 were observed in blood with peak levels of 1.7 mg/L seen 130 min after dosing, 50 min later than the peak FCE 22101 levels, and giving a mean AUC of 297 mg.min/L.

Administration, Oral↗
PubMed1991

Theatre over-shoes do not reduce operating theatre floor bacterial counts.

Occasional staff or visitors to operating theatres are usually requested to don over-shoes as this is perceived to reduce bacterial floor colony counts. However, this entails some expense and considerable inconvenience. Using disposable surface contact plates floor bacterial counts were measured four times a day at five different sites during the 5 normal working days of one 2-week period in a general operating theatre when over-shoes were worn and one 2-week period when over-shoes were not worn. There was no significant difference in the mean bacterial floor colony counts between the two periods according to sampling times or sites. As in Intensive Therapy units, over-shoes should no longer be used in general operating theatres.

Bacteria↗
PubMed1991

The effect of surgical theatre head-gear on air bacterial counts.

The wearing of disposable head-gear in operating theatres is currently recommended for scrubbed and non-scrubbed staff. However, there is little evidence of its effectiveness as an infection control measure in casual or non-scrubbed theatre staff. The effect of head-gear on bacterial air counts was studied, using six volunteers, in a sealed room, with and without ventilation. Using a Casella slit sampler and a SAS Air Sampler, air counts ranged from 0.08 to greater than 2.9 colony forming units (cfu) m-3. The wearing of head-gear was not associated with a reduction in air counts but counts were lower with ventilation. We recommend that non-scrubbed staff no longer wear head-gear as effective ventilation probably counteracts any possible increased bacterial shedding. Scrubbed staff should continue to wear disposable head-gear because of their proximity to the operative field.

Air Microbiology↗
PubMed1991

Listeria faecal carriage by renal transplant recipients, haemodialysis patients and patients in general practice: its relation to season, drug therapy, foreign travel, animal exposure and diet.

About 2.3% (16/700) of faecal specimens from renal transplant recipients and patients having home haemodialysis as well as patients attending their general practitioners with symptoms of gastroenteritis yielded Listeria species 40% of positive faeces contained more than one Listeria species or serovar. The proportion of positive specimens was similar in all three patient groups. Listeria were isolated from 5.6% (10/177) of renal transplant recipients on one or more occasions over the period of a year. The commonest species was L. monocytogenes and type 4b the commonest serovar. Carriage was more common in July and August than other times of year, and less than 28 weeks in duration. In renal transplant recipients carriage was positively related to treatment with ranitidine, consumption of more than three types of cheese in the previous 20 months, and consumption of English cheddar cheese more than once per week.

Animals↗
PubMed1991

Activity of clindamycin against Staphylococcus aureus and Staphylococcus epidermidis from four UK centres.

MICs of penicillin, methicillin, clindamycin, erythromycin, sodium fusidate and gentamicin were determined by an agar dilution method for 300 current isolates of Staphylococcus aureus and 100 of S. epidermidis, collected from four centres, and 38 stock strains of methicillin-resistant S. aureus (MRSA). All but one of the 300 current isolates of S. aureus were sensitive to clindamycin (MIC less than 0.5 mg/l), with an MIC90 of 0.12 mg/l. Of a total of 39 MRSA strains, 11 (28.2%) were resistant to clindamycin (MIC greater than 32 mg/l); all of these strains were also resistant to erythromycin. Ten of the 100 strains of S. epidermidis were resistant to clindamycin; they came from a reasonably equal geographical distribution and were also resistant to erythromycin. The results suggest that clindamycin might still be useful as a second-line agent for infections caused by S. aureus and S. epidermidis, although its activity against MRSA was limited to approximately two-thirds of the MRSA strains tested in this study.

Clindamycin↗
PubMed1991

The pharmacokinetics of lomefloxacin in elderly patients with urinary tract infection following daily dosing with 400 mg.

Eleven elderly patients (mean age 83 years; range 75-90) with microbiologically proven urinary tract infections were given 400 mg lomefloxacin as a single daily dose for up to seven days. On the first and final day of treatment blood was taken at timed intervals and drug concentration-time curves plotted. Blood was also taken immediately before each of the other doses for assay of pre-dose concentrations. The mean (+/- S.D.) peak serum concentration of lomefloxacin on the first day was 4.8 mg/l (+/- 1.5) observed at a mean of 156 min (+/- 88) and on the final day was 6.3 mg/l (+/- 2.5) at a mean of 119 min (+/- 68). The mean serum half-life on the first day was 10.0 h (+/- 2.8) and on the final day 10.3 h (+/- 2.5). The daily pre-dose serum concentrations of lomefloxacin showed no accumulation of the drug. No serious adverse events were reported and all patients were cured although two had persistent pyuria. It is suggested that a once daily dose of 400 mg lomefloxacin is suitable for the elderly and that no dosage modification is needed in this patient group.

Aged↗