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Biomedical subjects

H Thadepalli

Publications and source records attributed to H Thadepalli.

At least 91 records · Page 5Linked to original sources
PubMed1980

Bacteriology and treatment of dental infections.

The microbiologic and therapeutic aspects of sixty-one cases of pyogenic dental infection were studied through the use of modern anaerobic culture methods. Forty-five (74 percent) patients had anaerobic infections. Among them, eighteen (29.5 percent) had Bacteroides fragilis, of which six were resistant to penicillin at 16 microgram/ml. but all were susceptible to clindamycin at less than 2 microgram/ml. Of twenty-five patients treated with 4 to 20 million units of penicillin per day, twenty were cured and did not suffer relapse. The five patients in whom treatment failed had mandibular fractures infected with B. fragilis. Of ten patients treated with clindamycin (600 mg. intravenously every 6 hours), which included five patients with B. fragilis infections, all were cured. The presence of B. fragilis in dental infections has not been recognized. Dental infections associated with mandibular fracture that fail to respond to conventional penicillin therapy should be routinely cultured for B. fragilis.

Adolescent↗
PubMed1980

Netilmicin: its in vitro activity and synergism with penicillin compounds.

The in vitro efficacy of netilmicin and its synergism with penicillins were examined. Netilmicin was effective against E. coli, indole-negative and -positive Proteus, Klebsiella, Enterobacter, Salmonella, Shigella and Serratia. Netilmicin was less effective than other aminoglycosides against Citrobacter and Pseudomonas. A combination of netilmicin and piperacillin synergistically inhibited Enterococci. Netilmicin was not synergistic with either penicillin or carbenicillin against Enterococci. Netilmicin with either carbenicillin, ticarcillin or piperacillin synergistically inhibited Pseudomonas aeruginosa, but no such synergism was noted against highly resistant strains of Pseudomonas.

Amikacin↗
PubMed1980

Antimicrobial synergism of piperacillin and gentamicin against pseudomonas aeruginosa, Staphylococcus aureus and Streptococcus faecalis.

The potential synergistic effect of piperacillin with gentamicin was examined against five isolates each of Pseudomonas aeruginosa, Staphylococcus aureus and Streptococcus faecalis isolated from patients with endocarditis. Piperacillin and gentamicin synergistically inhibited all strains of P. aeruginosa and S. aureus tested. They exerted no synergistic effect against S. faecalis. Piperacillin and gentamicin synergism may be clinically tested in the treatment of serious pseudomonas and staphylococcal infections but not against infections caused by S. faecalis.

Drug Synergism↗
PubMed1980

In vitro susceptibility of anaerobic flora of the female genital tract to ampicillin compared to spectinomycin.

Pelvic inflammatory disease (PID) may be caused by anaerobic bacteria and or gonococcus and therefore the efficacy of two antibiotics, ampicillin (AMP) and spectinomycin (SPM) commonly used in this setting was examined against 370 isolates of anaerobic bacteria. At the highest therapeutically achievable serum levels, AMP (16 micrograms/ml) inhibited 83% of all anaerobes and 70% of Bacterioides fragilis, and SPM (128 micrograms/ml) inhibited 98% of all anaerobes and 95% of B. fragilis strains tested. It therefore appears that both AMP and SPM may have a place in the treatment of PID. In our study, greater percentage of anaerobes were susceptible to SPM than previously reported. We used the 'glove box' technique used for testing the susceptibility of anaerobes.

Ampicillin↗
PubMed1980

Susceptibility of anaerobic bacteria in vitro to 23 antimicrobial agents.

589 isolates of anaerobic bacteria, including 127 isolates of Bacterioides fracilis, were tested against 23 antimicrobial agents. At their usually achievable serum levels, carbenicillin, ticarcillin, mezlocillin and piperacillin; cefoxitin, minocycline, doxycycline, clindamycin, chloramphenicol and rifampin were effective against more than 80% of B. fragilis isolates. At usual therapeutic doses, penicillin (PEN), ampicillin (AMP), cyclacillin (CYC), cephalothin (CT), cefazolin (CZ), cephradine (CPD), cefamandole (CMD), cefaclor (CCL), cefuroxime (CRX), spectinomycin (SPT), tetracycline (TET), ethambutol (EMB) and isoniazid (INH) were ineffective against B. Fragilis. However, high and clinically tolerated doses of PEN, CMD and SPT inhibited more than 80% of B. fragilis isolates, but AMP, CYC, CT, CZ, CPD, CCL and CRX, TET, EMB and INH remained totally ineffective against B. fragilis. The therapeutic merits of these antibiotics are discussed.

Anaerobiosis↗
PubMed1980

Clinical evaluation of piperacillin.

28 patients with aerobic (7), anaerobic (7), and mixed (14) infections were treated with intravenous piperacillin for an average duration of 14 days. All bacterial isolates tested in this study were susceptible to piperacillin less than or equal to 128 micrograms/ml. 27 patients were treated with 20 g of piperacillin/day in four divided doses. 1 patient with renal failure received only 8 g/day. 26 patients were treated with piperacillin and two with Staphylococcus aureus infection received gentamicin in addition. The peak serum levels were 266 micrograms/ml at 1 h and the trough 16 micrograms/ml at 5 h. In all, 26 patients (93%) were 'cured', one had 'recurrence', and one 'failed'. Adverse effects were pruitus in two patients, transient elevation of LDH in one, and transient eosinophilia in another. In our preliminary study, piperacillin was found to be safe and effective in the treatment of clinical infections.

Adult↗
PubMed1980

Rapid diagnosis of anaerobic empyema by direct gas-liquid chromatography of pleural fluid.

Sixty samples of pleural fluid from 52 patients were subjected to direct gas-liquid chromatographic studies, and results were correlated with findings from microbiologic cultures. Fourteen patients had anaerobic empyema, 22 had aerobic infections, and 16 had sterile pleural effusions. Multiple volatile fatty acids or succinic acid or both were found as markers of anaerobic infection in all but one instance. Aerobic infections and sterile pleural fluids were characterized by the absence of multiple volatile fatty acids or succinic acid. Infection with Bacteroides, when present, was characterized by a major product of succinic acid. One patient infected with Peptococcus magnus (which does not produce fatty acids or succinic acid) could not be diagnosed by gas-liquid chromatograms. Two patients without anaerobic bacteria in the pleural effusions but who had infections associated with Bacteroides fragilis outside the pleural space demonstrated succinic acid in the pleural fluid. With these exceptions, the presence of volatile fatty acids or succinic acid in pleural fluid was considered characteristic of anaerobic empyema. Direct gas-liquid chromatographic study of pleural fluids is, therefore, recommended as a routine procedure for rapid diagnosis of anaerobic empyema.

Adult↗
PubMed1980

Tissue levels of doxycycline in the human lung and pleura.

Antibiotic concentrations in the human lung and pleural tissue were measured following intravenous administration of doxycycline. The average serum levels were 9.3, 7.0 and 3.0 micrograms/ml at 1, 2, and 3 hours; correspondingly, the lung tissue levels were 6.8, 3.5 and 2.3 micrograms/g. The pleural tissue antibiotic concentrations at the same time intervals were 2.5, 1.5, and 1.5 micrograms/g. This suggests that doxycycline is retained well by the lung and the pleura, well above the minimal inhibitory concentration of most of the common bacterial pathogens of the lung, and may be used in the treatment of lung infections caused by susceptible organisms.

Doxycycline↗
PubMed1979

Microflora of the human small intestine.

The human small intestine is normally sterile in nearly one half of North American subjects. In this study the duodenum, jejunum, and ileum were sterile in 82, 69, and 55 per cent of the cases, respectively. Gram-positive cocci were the most frequent finding. E. coli, Enterobacter, and Klebsiella were present in the small bowel in nearly 7, 15, and 35 per cent of duodenal, jejunal, and ileal samples, respecatively. They were present in significant numbers (greater than 1 X 10(5)/ml) in the mid-jejunum in two patients and in the mid-ileum in seven patients (23 per cent). Even with modern anaerobic techniques, anaerobes are scarce in the small bowel; 4 to 6 per cent of persons may have aerotolerant anaerobes like clostridia, but strict anaerobes like bacteroides are rare. Our study provides baseline data for use in interpreting the intestinal bacterial overgrowth associated with certain postoperative disorders.

Abdominal Injuries↗
PubMed1979

Identification of species of Candida, Cryptococcus, and Torulopsis by gas-liquid chromatography.

Gas-liquid chromatography was used to identify species of Candida, Cryptococcus, and Torulopsis by fatty-acid analysis of the whole-cell hydrolysate. Candida albicans characteristically revealed 2-OH C14:0 and C19:0 (chain length:number of double bonds); these were absent in other organisms. Candida curvata was characterized by a ratio of C16:1 to C16:0 of greater than 1.0. Candida guilliermondii contained C10:0, and Candida tropicalis had no C12:0, these features were used for their identification. Cryptococcus was characterized by the absence of C16:1. Torulopsis was characterized by a C16:1 to C16:0 ratio of greater than 10 accompanied by the presence of one unidentified fatty acid. These data suggested that certain Candida, Cryptococcus, and Torulopsis (the clinically important yeast-like organisms) may be identified by gas-liquid chromatography.

Candida↗
PubMed1979

In vitro activity of mezlocillin and its related compounds against aerobic and anaerobic bacteria.

A total of 900 clinical isolates of aerobic (462 isolates) and anaerobic (438 isolates) bacteria were tested against mezlocillin in comparison with other penicillins, and the aerobes were also tested against cephalothin, cefoxitin, and cefamandole. Among penicillins, mezlocillin was the most effective against Escherichia coli, Klebsiella pneumoniae, Salmonella species, Pseudomonas aeruginosa, and Bacteroides fragilis. Mezlocillin was more effective than cephalothin against Klebsiella pneumoniae.

Aerobiosis↗
PubMed1979

Clinical evaluation of mezlocillin.

The safety and efficacy of intravenous mezlocillin were determined in 25 patients with aerobic, anaerobic, and mixed infections. Included were pleuropulmonary, urinary tract, skin, and soft-tissue infections, osteomyelitis, and abdominal and breast abscess. Nineteen patients (76%) were cured without recurrence as determined by clinical and bacteriological parameters. In three, the infection recurred (12%); two patients failed (8%), and in one, it was indeterminate (4%). No serious adverse effects were noted except for severe thrombophlebitis in three (12%) patients. Our preliminary data suggest that mezlocillin is a safe (except for thrombophlebitis) and effective antibiotic in the treatment of aerobic anaerobic, and mixed infections.

Abscess↗
PubMed1979

Clinical and experimental evaluation of cefoxitin therapy.

30 patients were treated with i.v. cefoxitin (4-8 g/day), of which 20 had documented infections which included endocarditis (5), lung abscess (4), empyema (4), liver and subhepatic abscess (3), osteomyelitis (3), and pancreatic abscess (1). 14 patients had infections caused by anaerobic bacteria and 5 had endocarditis due to aerobic organisms. All but 2 patients with osteomyelitis of the mandible were cured. Adverse reactions were noted in 7 patients, mostly due to drug fever and leukocytosis; one had Coombs'-positive hemolytic anemia. The average serum cefoxitin levels were 24, 16, 12, and 4 microgram/ml at 1, 2, 3 and 4 h, respectively, and the average serum/pleural fluid ratio was 1:0.5 +/- 0.25. All anaerobic and aerobic isolates except one strain of Bacteroides fragilis were susceptible to cefoxitin at less than or equal to 32 microgram/ml. The concentration of cefoxitin in the tissues was measured in 8 rabbits; it was 4 +/- 1 microgram/ml in the heart and 2 +/- 0.5 microgram/ml in the femur and mandibular tissue, suggesting that the lack of response in cases of osteomyelitis could be due to inadequate antibiotic concentration in the bone. Our study suggests that cefoxitin can be used in the treatment of anaerobic infections and endocarditis due to susceptible organisms.

Abscess↗
PubMed1979

Cyclacillin: in vitro activity against aerobic and anaerobic bacteria.

Cyclacillin at 50 microgram/ml inhibited streptococci (100%), shigella (72%), and Bacteroides (B) fragilis ss fragilis (84%). At 100 microgram/ml it inhibited proteus (75%), B. fragilis (86%), and E. coli (50%). Cyclacillin was more effective than ampicillin against beta-lactamase-producing H. influenzae. The activity of cyclacillin was found to be more enhanced when tested in nutrient agar and Mueller-Hinton agar than in brain heart infusion agar.

Ampicillin↗
PubMed1979

Antimicrobial activity of antituberculosis agents against anaerobic bacteria.

Anaerobic infections may coexist with tuberculosis, and can be mistaken for one another. The effect of therapy with antituberculosis chemotherapeutic agents against anaerobic bacteria (with the exception of rifampin) is unknown. We therefore examined the in vitro efficacy of certain commonly used antituberculosis agents (rifampin, isoniazid, and ethambutol) against 370 strains of anaerobic bacteria, including 86 isolates of Bacteroides fragilis. Rifampin at a concentration of 2 microgram/ml inhibited 91 percent of all anaerobic isolates. Both ethambutol and isoniazid were totally ineffective against any of the anaerobes tested, even at 64 microgram/ml. Therapy with rifampin in an unsuspected anaerobic infection can be misdiagnosed for tuberculosis. Therefore, when tuberculosis is suspected, isoniazid and ethambutol can be used and rifampin withheld until the acid-fast bacilli are demonstrated by additional diagnostic procedures, such as transtracheal aspiration.

Actinomyces↗
PubMed1979

Hemoptysis in patients with septic pulmonary infarcts from tricuspid endocarditis.

Three drug addicts with tricuspid valve endocarditis and pulmonary cavitation secondary to septic pulmonary infarcts developed massive hemoptysis. Two patients died of asphyxia and one survived. Both who died were improving clinically and had negative blood cultures when the fatal hemoptysis occurred. Therefore, however slight it may be, hemoptysis occurring in association with septic pulmonary infarcts associated with endocarditis may require prompt and aggressive measures.

Adult↗