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L V White

Publications and source records attributed to L V White.

4 recordsLinked to original sources
PubMed1994

The use of antimicrobial drugs in Nagpur, India. A window on medical care in a developing country.

The objective of the study was to determine the patterns of use of antimicrobial drugs in the general population of the large, industrial city of Nagpur, India. Interviews of pharmacists and clients were carried out in a stratified, random sample of 34 pharmacies to determine beliefs and practices in prescribing and self-prescribing of antibiotics by complaint, choice of drug, dose, duration, cost, age and sex of the consumers. The study showed that drugs were dispensed without prescription despite prohibition by the Indian Pharmaceutical Act. Sales of antimicrobial drugs accounted for 17.5% of 511 purchases and 23.3% of expenditures for drugs. Proprietary brands of penicillins, co-trimoxazole and tetracyclines were dispensed most often (64.8%). The most common indications were upper respiratory, gastrointestinal and nonspecific complaints. The median number of units obtained was 5.0 (95% range 1-20), at a median cost of $0.50 per purchase, usually taken for less than five days. Repeat purchases were made without consulting a physician. Almost two thirds of purchases (63.9%) were for males, mainly under the age of ten years. Clients had poor knowledge of the indications, side effects, adverse reactions and appropriate duration of therapy. The dispenser viewed himself as a businessman rather than a professional and rarely offered unsolicited advice. Co-prescribing of 'tonics' added to costs and decreased the purchasing power for antimicrobial drugs. Most purchases of antimicrobial drugs in community pharmacies in Nagpur were for minor indications and were limited by the purchasing power of the consumers. It is doubtful that the choice of drug and the short duration of therapy would be effective for serious infections.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

A reassessment of the importance of "low-count" bacteriuria in young women with acute urinary symptoms.

OBJECTIVE: To determine whether a statistical association exists between "low-count" bacteriuria (> 10(2) to 10(4) colony-forming units/mL) and acute urinary symptoms in young women. DESIGN: Prospective, case-control study. SETTING: Gynecology clinic at a student health center. PATIENTS: Women with or without urinary or vaginal symptoms. MEASUREMENTS: History of urinary infections and sexual activity. Quantitative determination of bacteriuria and pyuria and bacterial species; urine leukocyte esterase test; specific gravity; creatinine levels; vaginal leukocytes; and in-vitro culture of urine. RESULTS: The frequency of recent sexual activity, pregnancies, and contraceptive practices was not statistically different between women with acute urinary symptoms and asymptomatic controls. Escherichia coli and Staphylococcus saprophyticus were the only microorganisms statistically associated with urinary symptoms and pyuria (P < 0.001). Low counts of these organisms were found in 10.2% of asymptomatic women. As the bacterial count increased, the association between these organisms and symptoms increased, and a step-wise increase occurred in the frequency and magnitude of pyuria, but the specific gravity and urine creatinine levels remained unchanged. Escherichia coli, even at low counts, grew well in the patients' own urine. Pyuria (> 20 leukocytes/mm3) was present in 19.6% of asymptomatic women and was associated with vaginal leukorrhea. CONCLUSIONS: "Low-count" bacteriuria was statistically more frequent among young women with urinary symptoms than among asymptomatic controls. The low counts could not be explained by dilution of the urine or failure of the bacteria to grow well in the patients' urine. These findings suggest that the infection was not established in the bladder urine and that "low-count" bacteriuria might be an early phase of urinary tract infection.

Acute Disease↗
PubMed1993

Do temperature-sensitive auxotrophs of Escherichia coli have special virulence?

To determine whether temperature (42 degrees C)-sensitive auxotrophs of Escherichia coli have special virulence properties (W. D. Welch, D. Kitts, H. S. Moyed, and L. D. Thrupp, J. Clin. Microbiol. 13:606-608, 1981), we examined 301 strains isolated from patients with bacteremia or acute cystitis and from the stools of healthy subjects. Of these strains, 49.5% grew at 42 degrees C without supplements, 39.2% required a nutritional supplement, and 11.3% failed to grow even with selected nutrients. Nicotinamide restored growth for 35.2% of strains at either 37 or 42 degrees C. Some of strains required methionine, glutamic, aspartic, and amino acid mixtures or NaCl for growth at 42 degrees C. Temperature-sensitive strains were significantly more abundant in isolates from blood and urine than in stool, but temperature-sensitive auxotrophs were isolated at about the same frequency from each site. There were no discernible clonal patterns, by serotype, among of the nicotinamide-requiring temperature-sensitive auxotrophs. Resistance to trimethoprim-sulfamethoxazole was associated with ability to grow at 42 degrees C. This was not observed with any other antimicrobial drug. Temperature-sensitive strains are a heterogenous group. The relationship of temperature-sensitive auxotrophy to virulence is uncertain.

Bacteremia↗