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L J Strausbaugh

Publications and source records attributed to L J Strausbaugh.

66 records · Page 4Linked to original sources

Cefamandole and ampicillin therapy in experimental Haemophilus influenzae meningitis.

Cefamandole and ampicillin were compared in the therapy of experimental Haemophilus influenzae meningitis in rabbits. Three dosages of each drug were administered as a continuous intravenous infusion for 8 hr to 24 infected animals. Samples of serum and cerebrospinal fluid (CSF) were obtained at 0, 4, and 8 hr for determination of antibiotic concentrations and bacterial titers in CSF. Serum levels of cefamandole were higher, but CSF concentrations of both antibiotics were similar. With the 60-mg/kg per hr dose, the mean serum level was 106 +/- 61 mug/ml for cefamandole and 58 +/- 32 mug/ml for ampicillin (P less than 0.05). With this dosage the mean level in CSF was 7.3 +/- 8.4 mug/ml for cefamandole and 9.5 +/- 5.4 mug/ml for ampicillin (P = 0.26). The percentage penetration ([concentration in CSF/concentration in serum] X 100%) was higher for ampicillin (mean, 18.8% +/- 8.9%) than for cefamandole (mean, 5.6% +/- 3.8%) with all dosages tested (P less than 0.001). The rate of bacterial killing in vivo during therapy was similar with both drugs. The efficacy of cefamandole and ampicillin given intramuscularly for five days (250 mg every 8 hr) was examined in 42 rabbits. Twelve of 14 untreated control rabbits died within 24-72 hr of inoculation. In contrast, 11 of 14 rabbits treated with cafamandole and 10 of 14 rabbits treated with ampicillin were cured of their infections. Cefamandole compared favorably with ampicillin in the therapy of experimental H. influenzae meningitis.

Ampicillin↗

Comparison of four aminoglycoside antibiotics in the therapy of experimental E. coli meningitis.

Tobramycin, sisomicin, and amikacin were compared with gentamicin in the therapy of experimental E. coli meningitis in rabbits. Meningitis was produced in 40 animals by intracisternal injection of 10(5) E. coli. Three dosages of each antibiotic were administered intravenously over 8 hours. Serum and CSF samples were obtained at 0,2,4,6, and 8 hours for determination of aminoglycoside concentrations and CSF bacteria counts. The four aminoglycosides demonstrated comparable penetration into the CSF. The mean percent penetration (CSF conc./serum conc. X 100%) with the three dosages was 10 to 50% for gentamicin, 8 to 23% for tobramycin, 6 to 16% for sisomicin, and 11 to 23% for amikacin. This variation in penetration reflected individual differences in each dosage group and the increase in percent penetration that was observed during therapy. Sisomicin and gentamicin were consistently bactericidal in vivo. Mean CSF bacterial titers gentamicin were consistently bactericidal in vivo. Mean CSF bacterial titers decreased 3.07 logs in rabbits treated with sisomicin and 2.44 logs in animals treated with gentamicin. Even through CSF concentrations were comparable, the group treated with tobramycin demonstrated only a 0.64 log decrease and the amikacin group had a 0.45 log increase in mean CSF titers. The bactericidal effect of sisomicin appeared to be more rapid than that of gentamicin. During the first 2 hours of therapy CSF titers declined 1.02 logs in animals treated with sisomicin as compared to 0.37 log in animals receiving gentamicin even though gentamicin concentrations were higher (mean 7.4 vs. 4.1 gm./ml.). Sisomicin also demonstrated greater bactericidal activity than the other aminoglycosides in normal CSF in vitro. The results of this study suggest that sisomicin may be of value in the therapy of E. coli meningitis.

Amikacin↗

Ampicillin and an ester in experimental Hemophilus influenzae meningitis.

A new methoxymethyl ester of hetacillin is highly lipid-soluble, a property which was expected to enhance its penetration into the central nervous system (CNS). We compared the penetration of the ester and ampicillin into the cerebrospinal fluid (CSF) of normal rabbits and those with experimental Hemophilus influenzae meningitis. In normal rabbits treated by constant intravenous infusion, mean per cent penetration (see article) of the ester was four times as great as that of ampicillin (6.6 +/- 3.7% against 1.6 +/- 1.9%), and the difference in CSF drug levels attained was accentuated when bolus IV infusion was used. Drug concentration in brain tissue was three times as great in a rabbit treated with the ester (0.79 mug/gm against 0.26 mug/gm). In rabbits with meningitis, the ester again achieved higher CSF concentrations. Per cent penetration into CSF in infected rabbits was 23% for the ester and 13% for ampicillin. Bactericidal activity of the drugs was comparable; over 8 hr of treatment both drugs significantly reduced the CSF bacterial titers of infected animals. Our data demonstrated that the ester enters the CSF and CNS in higher concentration than ampicillin, with no loss in bactericidal activity.

Ampicillin↗

Comparative pharmacology of josamycin and erythromycin stearate.

Two macrolide antibiotics, josamycin and erythromycin stearate, were administered orally to healthy, adult male volunteers for a comparative study of their pharmacological properties. In comparable doses, josamycin and erythromycin produced similar plasma concentrations, with similar half-lives and elimination constants. An initial loading dose of 1.5 g of josamycin produced greater peak concentrations of antibiotic throughout a 10-day period with a regimen of every 6 h. In addition, josamycin tended to reach higher peak and trough concentrations after regimens of every 6 or 8 h were maintained for 2 days. Josamycin penetrated into saliva, sweat, and tears, and it was better tolerated in fasting subjects than was erythromycin stearate.

Adult↗

Antimicrobial activity, pharmacokinetics, adverse reactions, and therapeutic indications of cefoperazone.

Cefoperazone is a parenteral cephalosporin antibiotic that is pending approval by the U. S. Food and Drug Administration. Compared to most other cephalosporins cefoperazone has a greatly expanded spectrum of bactericidal activity that encompasses most aerobic gram-positive bacteria except enterococci, most aerobic gram-negative bacteria, including a majority of Pseudomonas aeruginosa strains, and a number of pathogenic anaerobic bacteria. Its long serum half-life, approximately two hours, permits a twelve hourly dosing schedule. No dosage modification is required in patients with renal insufficiency, and only minor modification is needed in patients with hepatic insufficiency or biliary obstruction. Clinical trials have established cefoperazone's efficacy in lower respiratory tract infections, urinary tract infections, and a variety of other bacterial infections. Adverse reactions have been infrequent, and few serious reactions have been identified. Cefoperazone is a promising new agent for the treatment of gram-negative bacillary and polymicrobial infections, especially in settings that require empiric therapy.

Bacteria↗

Vertebral osteomyelitis and native valve endocarditis caused by Staphylococcus warneri.

Coagulase-negative staphylococci almost invariably cause significant clinical infections in the setting of prosthetic devices or severely compromised host defenses. Hematogenous osteomyelitis and native valve endocarditis due to these pathogens in any setting is rare. We report a case of community-acquired vertebral osteomyelitis and native valve endocarditis due to Staphylococcus warneri in a patient with none of the usual risk factors.

Aged↗

Cefoperazone therapy for obstetric and gynecologic infections.

The safety and clinical efficacy of cefoperazone therapy for obstetric and gynecologic infections have been evaluated in clinical trials involving 107 women hospitalized at nine medical centers. The indications for cefoperazone therapy have included post-partum and postoperative uterine infections, pelvic inflammatory disease, postoperative pelvic infections, and miscellaneous pelvic infections. A variety of aerobic and anaerobic bacteria, including members of the genera Staphylococcus, Streptococcus, Escherichia, Klebsiella, Proteus, Neisseria, Bacteroides, Peptococcus, and Peptostreptococcus, were isolated from these patients. More than 80% of these isolates were inhibited in vitro by cefoperazone concentrations less than or equal to 2.0 micrograms/ml. Symptomatic cures were achieved in 91% of patients, and 96% of isolated pathogens were eradicated during therapy. Adverse drug-related reactions occurred in only 4% of patients. Follow-up laboratory evaluations demonstrated only minor abnormalities that affected a small number of patients. These results indicate that cefoperazone offers safe and effective therapy for common obstetric and gynecologic infections.

Adolescent↗

Emerging health care-associated infections in the geriatric population.

The increasing number of persons >65 years of age form a special population at risk for nosocomial and other health care-associated infections. The vulnerability of this age group is related to impaired host defenses such as diminished cell-mediated immunity. Lifestyle considerations, e.g., travel and living arrangements, and residence in nursing homes, can further complicate the clinical picture. The magnitude and diversity of health care-associated infections in the aging population are generating new arenas for prevention and control efforts.

Aged↗