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H Thadepalli

Publications and source records attributed to H Thadepalli.

132 records · Page 8Linked to original sources
PubMedDate not supplied

Cefoxitin therapy for bacterial endocarditis.

Of 22 patients who were suspected of having bacterial endocarditis and who were treated with cefoxitin intravenously (8-12 g per day), 12 were evaluated for responses to therapy. Ten patients had infections due to a single pathogen, and two had polymicrobial infections. Staphylococci were isolated from eight patients, and streptococci from four; both of these pathogens were susceptible to 2-16 micrograms of cefoxitin/ml. Staphylococcus aureus and four strains of anaerobic bacteria, including Bacteroides fragilis (minimal inhibitory concentration, 32 micrograms/ml), were isolated from one patient. The average level of cefoxitin in serum was 32.8 micrograms/ml (range, 14.5-64 micrograms/ml) at 1 hr after an intravenous dose of 2 g; after 5 hr the average level in serum was 8.5 micrograms/ml (range, 2-20 micrograms/ml). The mean (+/- SD) level of cefoxitin in myocardial tissues from eight rabbits at 1 hr following a 250-mg/kg dose of the antibiotic was 4 +/- 0.5 micrograms/g. On the average, patients were treated for 29 days (range, 14-40 days), and they became afebrile in 6.2 days (range, three to 20 days). Both clinical and microbiologic responses to cefoxitin therapy were excellent in 10 patients with monobacterial infections. Both patients with polymicrobial infections were not cured. One, who was infected with a mixed flora of anaerobes, died; the other was cured after surgical valvectomy. These results suggest that cefoxitin is effective in the treatment of endocarditis due to a single susceptible organism but that this antibiotic should be used with caution in patients whose endocarditis is caused by a mixed population of bacterial pathogens.

Adult↗
PubMedDate not supplied

Ciprofloxacin: in vitro, experimental, and clinical evaluation.

Ciprofloxacin at a concentration of 2 micrograms/mL inhibited the growth of approximately 90% of 584 strains of aerobic bacteria isolated from cultures of blood drawn from septicemic patients. An increase in the inoculum size did not result in an increased MIC, but serial passages through media containing ciprofloxacin at sub-MIC levels increased the MIC for Escherichia coli, Klebsiella pneumoniae, and Proteus vulgaris. In experimental subcutaneous abscesses in the mouse model, ciprofloxacin was more active than cefotaxime against a mixed infection induced with E. coli and Bacteroides fragilis. Against mixed E. coli and Staphylococcus aureus infection, no significant differences were noted between the two drugs. In a double-blind, prospective, randomized clinical study, perorally administered ciprofloxacin was compared with intravenously administered cefotaxime in the treatment of skin and soft-tissue infections severe enough to require hospitalization. In 70 patients treated, the therapeutic efficacy of peroral ciprofloxacin was comparable to that of intravenous cefotaxime, with two differences: S. aureus infections responded less favorably to oral ciprofloxacin (62%) than to intravenous cefotaxime (90%), and aerobic gram-negative bacillary infections responded more favorably to ciprofloxacin (92%) than to cefotaxime (64%).

Abscess↗
PubMedDate not supplied

Clindamycin: a review of fifteen years of experience.

Clindamycin, the 7(S)-chloro-7-deoxy derivative of lincomycin, has stood the test of time in the treatment of anaerobic infections. Clindamycin inhibits protein synthesis by acting on the 50S ribosomal subunits of bacteria. The colitis resulting from the use of clindamycin has been extensively studied and is now easily manageable. Although newer antibiotics active against anaerobes are available, clindamycin remains a reliable and well-tested antibiotic for use in anaerobic infections.

Animals↗
PubMedDate not supplied

Cardiac tuberculosis: TB of the endocardium.

Tuberculosis involving the endocardium is extremely rare. The diagnosis is usually made during autopsy. Often there is involvement of other parts of the heart as well as other regions of the body. The infection is a result of direct extension from the myocardium or hematogenous spread. Two cases of disseminated tuberculosis with endocardial involvement are reported. In Case 1 miliary tuberculosis was diagnosed during life but the patient succumbed to extensive disease on the third hospital day. The patient in Case 2 presented with congestive cardiac failure and the possibility of tuberculosis was not suspected during life.

Aged↗
PubMedDate not supplied

Bacteroides fragilis-induced intra-abdominal abscess in an experimental model treated with telithromycin (HMR 3647).

BACKGROUND: Telithromycin (HMR 3647), a novel ketolide, is known to have activity against Bacteroides fragilis in vitro. METHODS: We tested this ketolide in an animal model of intra-abdominal abscess produced by intraperitoneal injection of B. fragilis with sterile feces and BaSO(4) mixture. Telithromycin was tested at two doses, 1. 25 and 2.0 mg/dose twice daily, and compared with clindamycin, cefotetan or metronidazole, all given at 2.0 mg/dose twice daily for 10 days. Absence of bacteria at the infected site was considered a cure and a positive culture considered a failure. RESULTS: The cure rate was 18% (5/28) on saline therapy, 74% (20/27) on telithromycin and 82% (23/28) on clindamycin, whereas it was 61% (17/28) on metronidazole and 59% (16/27) on cefotetan therapy. A high tissue antibiotic concentration (3-5 times the MIC) of telithromycin was found and this is presumably related to its superior efficacy. Delayed therapy initiated 7 days after infection instead of immediate therapy cured only 32% of the animals treated. The lower dose of telithromycin (1.25 mg/dose twice daily) was as effective as the higher dose (2 mg/dose twice daily). CONCLUSIONS: We found that telithromycin is as effective as clindamycin and more effective than metronidazole and cefotetan in this experimental model. These results suggest that telithromycin may be tested in future for the treatment of B. fragilis infections in humans.

Abdominal Abscess↗