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Biomedical subjects

M S Simberkoff

Publications and source records attributed to M S Simberkoff.

112 records · Page 7Linked to original sources

Intravenous pharmacokinetics and in vitro bactericidal activity of trimethoprim-sulfamethoxazole.

Trimethoprim-sulfamethoxazole (240 mg of trimethoprim plus 1,200 mg of sulfamethoxazole) was administered intravenously in a volume of 200 ml to 7 volunteers every 12 hr for 4 days. The mean peak levels of TMP and SMZ in plasma were 3.22 and 100 micrograms/ml, respectively, on day 1 and 5.91 and 178 micrograms/ml, respectively, on day 4, when a steady state was achieved. Tests of in vitro susceptibility indicated that these concentrations are bactericidal for a large proportion of enteric gram-negative bacilli.

Adult↗

Penicillin sensitive nutritionally variant streptococcal endocarditis: relapse after penicillin therapy.

Studies to date have indicated that nutritionally-variant streptococci (NVS) causing bacterial endocarditis are frequently inhibited but not killed by low concentrations of penicillin. We report a patient with endocarditis due to a NVS strain which was killed in vitro by penicillin at a concentration of 0.09 microgram/ml. Despite therapy with intravenous penicillin for four weeks, the infection relapsed and was then cured by combined penicillin-gentamicin in therapy. In vitro studies demonstrated a synergistic effect of these two antibiotics. This experience suggests that combination therapy with penicillin and an aminoglycoside may be required for cure of all cases of nutritionally-variant streptococcal endocarditis regardless of in vitro susceptibility to penicillin.

Aged↗

Myocardial abscess due to Klebsiella pneumoniae complicating acute infarction.

A case is described in which Klebsiella pneumoniae urosepsis associated with acute myocardial infarction resulted in myocardial abscess and papillary muscle rupture. The diagnosis was made during surgery for mitral valve replacement. The patient improved after therapy with cefotaxime; however, cardiac rupture occurred on the sixth postoperative day. The pathogenesis of myocardial abscess and the use of non-invasive techniques for diagnosis are discussed.

Abscess↗