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H R Stutman

Publications and source records attributed to H R Stutman.

59 records · Page 4Linked to original sources
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In vitro activity of teicoplanin compared with vancomycin against methicillin-resistant Staphylococcus aureus derived from cystic fibrosis sputum.

We evaluated the in vitro activity of teicoplanin compared with vancomycin against methicillin-resistant Staphylococcus aureus (MRSA) derived from cystic fibrosis (CF) sputum. Teicoplanin had a slightly lower median minimum inhibitory concentration (MIC) for these strains (0.25 micrograms/ml) than did vancomycin (0.5 micrograms/ml). Inoculum size increased the MICs similarly for both drugs, and pH variations did not significantly affect their activity. The presence of serum and sputum in the growth media decreased the activity of both drugs, although this was more pronounced for teicoplanin which is highly protein bound. We conclude that teicoplanin has activity against this pathogen and might be evaluated in clinical protocols designed to address this emerging clinical problem.

Culture Media↗
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Clinical experience with aztreonam for treatment of infections in children.

The in vitro activity, pharmacokinetics, bactericidal activity, and tissue penetration of aztreonam suggest that it may play a role in therapy for serious gram-negative bacterial infections in children. Several thousand children throughout the world received aztreonam during open or comparative clinical trials for treatment of infections including pyelonephritis, bacteremia, meningitis, skeletal infection, pneumonia, and peritonitis. Cure rates have ranged from 92% to 100%, with relapses seen mainly in children with obstructive renal lesions and those with infections caused by Salmonella. A comparative trial of aztreonam for treatment of neonatal sepsis showed it to be at least as effective as amikacin for this infection. Aztreonam yielded clinical results comparable to those of conventional combined therapy for pulmonary infection in patients with cystic fibrosis. Adverse effects in pediatric trials have been uncommon; fever, diarrhea, or rash occurred in less than 2% of treated children. Reversible laboratory abnormalities have occasionally been noted. On the basis of these data, aztreonam is considered an appropriate alternative agent for the treatment of serious gram-negative bacterial infections in neonates and children. Further comparative clinical trials will delineate specific indications.

Aztreonam↗
PubMedDate not supplied

Comparison of lysis-direct plating and broth methods for pediatric blood cultures: clinical relevance and cost effectiveness.

To determine the clinical significance and therapeutic impact of pediatric blood cultures, we analyzed 1650 cultures comparing conventional broth and direct plating methods. The rate of positive cultures was 5.8%. Of 96 positive cultures 68 were deemed clinically significant. The mean time to detection was 23.8 and 33.7 hours, and the sensitivity was 89 and 83% in the Isolator and broth systems, respectively. The overall rate of insignificant isolates was 1.7% and was similar for both methods. Clinical interventions based on blood culture results occurred in 39 patients, primarily those with pneumococcal and staphylococcal bacteremia. Only six of 28 clinically insignificant isolates had negative impact. Use of the pediatric Isolator permitted earlier institution of appropriate therapies and shorter duration of unneeded or toxic therapies without frequent negative impact. Since direct costs were comparable the Isolator system may be a clinically valuable and cost effective alternative to conventional methodology.

Bacterial Infections↗