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Biomedical subjects

W Brumfitt

Publications and source records attributed to W Brumfitt.

At least 91 records · Page 5Linked to original sources
PubMed1986

Cefonicid, a long acting cephalosporin: in vitro activity compared with three cephalosporins and gentamicin.

Minimum inhibitory concentrations of cefonicid, cefazolin, cefuroxime, ceftazidime and gentamicin were determined against 688 bacterial strains (234 Gram-positive and 454 Gram-negative) from 20 different genera. Cefonicid showed a broader spectrum than cefazolin but was not as active as ceftazidime or gentamicin. Cefonicid most closely resembled cefuroxime in terms of microbiological properties. Disc testing accurately predicted sensitivity to cefonicid except for Staphylococcus aureus (which was sensitive by MIC, but appeared resistant in the disc test) and Proteus vulgaris (which was resistant by MIC but appeared sensitive in the disc test). In combination with gentamicin, synergy or addition was observed in 94% of 35 strains tested by the chequerboard technique. In view of its long half-life and wide range of microbiological activity, cefonicid promises to be a useful addition to the range of cephalosporins already available.

Cefamandole↗
PubMed1985

In vitro activity of six antibiotics against multiresistant staphylococci and other gram-positive cocci.

Sixty-two strains of Staphylococcus aureus and coagulase-negative staphylococci, 21 Streptococcus faecalis and 17 other strains of streptococci isolated from cases of endocarditis were tested for sensitivity against rifampicin, teicoplanin, vancomycin, fusidic acid, erythromycin and novobiocin. Only rifampicin, novobiocin and teicoplanin were found to be active against the great majority of these strains. The microbial properties of these antibiotics suggest the necessity of combinations for effective therapy. The combinations rifampicin + novobiocin and rifampicin + teicoplanin were additive and suppressed the emergence of resistant mutants. Thus according to in vitro tests, either of these two combinations would be suitable for prophylactic use in high-risk patients, especially those scheduled to receive prosthetic implants.

Anti-Bacterial Agents↗
PubMed1985

A clinical comparison between Macrodantin and trimethoprim for prophylaxis in women with recurrent urinary infections.

Seventy-two patients with a history of at least three attacks of urinary infection in the previous 12 months were assigned randomly to long-term prophylaxis with 100 mg at night of either Macrodantin (34 patients) or trimethoprim (38 patients). The mean interval between symptomatic attacks while on either treatment was increased three-fold compared with the pretreatment period. Macrodantin was significantly more effective (P less than 0.05) at preventing bacteriuria. Prophylaxis was equally effective in patients with and without a radiological abnormality. Side effects were significantly more common (P less than 0.05) in the group taking Macrodantin. In patients taking trimethoprim acquisition of resistance by faecal coliforms occurred at a rate of about 5%/month, and breakthrough infections were almost exclusively caused by trimethoprim-resistant coliforms. No acquisition of resistance occurred in patients taking Macrodantin, and the few breakthrough infections noted were due to sensitive bacteria.

Feces↗
PubMed1985

Successful use of reduced dosage of cinoxacin in the treatment of recurrent urinary infection.

Ninety-seven patients with a history of recurrent bacteriuria were treated with cinoxacin in a dosage of either 250 mg (48 patients) or 500 mg (49 patients) 12-hourly for seven days. Both regimens had a success rate in excess of 85% one week after the end of treatment, and only 15% of the patients rendered abacteriuric had relapsed four weeks later. Both dosage regimens of cinoxacin were very well tolerated. Our results show that in patients with recurrent urinary infections the conventional dosage of cinoxacin (500 mg) can be reduced to 250 mg 12-hourly without any loss of efficacy. Consequently patients seen in family practice with uncomplicated lower tract urinary infection can confidently be expected to respond equally well to a dose of 250 mg 12-hourly with the obvious advantages of less toxicity, less chance of producing resistance in the bowel flora and lower cost.

Adult↗
PubMed1985

Relationship between adhesion of Escherichia coli to uro-epithelial cells and the pathogenesis of urinary infection: problems in methodology and analysis.

Escherichia coli strains isolated from patients with urinary infections were tested for their ability to adhere to human uro-epithelial cells. In any single experiment, the numbers of bacteria adhering to individual uro-epithelial cells showed great variations; some cells had hundreds of bacteria adhering to them whereas other cells had few or none. This non-Normal distribution of bacterial attachment must be taken into account when carrying out statistical analyses of the results. The wide discrepancies reported in the literature regarding bacterial adhesion to uro-epithelial cells must, in part, be related to the type of statistical analysis used. In many cases, a Normal rather than a non-Normal distribution has been assumed. We found that even when all variables were kept constant, the experiment was still not reproducible. Therefore the technique shows a high degree of both inter- and intra-experimental error. Adhesion depended on such factors as the type of fimbriae produced by the bacteria, differing viability of uro-epithelial cells and varying pH of the medium used for a particular experiment. It is concluded that the results of in-vitro experiments demonstrating adhesion of E. coli to uro-epithelial cells are difficult to relate to bacterial adhesion in vivo but better results could be obtained if more attention were paid to standardisation of methods and their analysis.

Adhesiveness↗
PubMed1985

Trimethoprim alone compared to co-trimoxazole in lower respiratory infections: pharmacokinetics and clinical effectiveness.

24 patients, admitted to hospital with lower respiratory tract infection, were treated with either co-trimoxazole (800 mg sulphamethoxazole + 160 mg trimethoprim) or trimethoprim (200 mg) orally twice daily. All showed a clinical improvement and with one exception respiratory pathogens were eliminated. Pharmacokinetics in blood, sputum and saliva were studied in 11 patients taking trimethoprim and 9 taking co-trimoxazole. No sulphamethoxazole was detected in either the sputum or saliva. Trimethoprim was found in higher concentrations in the sputum than in the blood, although there were wide and significant variations in individual patient's sputum pharmacokinetic profiles. Trimethoprim penetrates into the sputum at therapeutic concentrations in patients with chronic respiratory infections.

Adolescent↗
PubMed1984

Sodium content of injectable beta-lactam antibiotics.

Many users of antibiotics are unaware of their ionic content. The ionic content is a particularly important factor for injectable beta-lactam compounds in patients on a restricted sodium intake. A table of the sodium content of commonly prescribed beta-lactam compounds is provided.

Anti-Bacterial Agents↗
PubMed1984

Stability of aminoglycoside resistance in vitro in gentamicin-resistant Staphylococcus aureus.

Stability of aminoglycoside resistance has been investigated in 20 strains of Staphylococcus aureus resistant to gentamicin (16 strains were also resistant to methicillin). In view of previous reports that incubation at elevated temperatures can hasten the loss of unstable antibiotic resistance, we passaged strains daily in a liquid medium for 24 days at 43 degrees C. The nine strains which were resistant to neomycin kept their aminoglycoside resistance virtually intact, whereas most of the other 11 strains (sensitive to neomycin) lost almost all their resistance to gentamicin and kanamycin after 5 days. It thus appears that the stability of aminoglycoside resistances in Staph. aureus is closely linked to the resistance of the strains to neomycin. This finding has important possible consequences in terms of the advisability of the clinical usage of preparations containing neomycin or framycetin for topical application and bowel sterilization.

Amikacin↗
PubMed1984

Activity of rifampicin against staphylococci, with special reference to multiresistant strains.

Antibiotic-sensitive and multiply-resistant isolates of Staphylococcus aureus and Staph. epidermidis were all sensitive to rifampicin (MIC less than or equal to 0.015) mg/l) and to novobiocin, vancomycin and teicoplanin (MICs less than 1 mg/l). No tolerance was observed. Resistance sometimes developed in bactericidal tests on rifampicin or novobiocin alone, but not with vancomycin or teicoplanin, or with combinations. The implications of these findings are discussed in the context of serious infections with staphylococci, especially those resistant to beta-lactams and aminoglycosides.

Anti-Bacterial Agents↗
PubMed1984

Importance of methodology in determining bactericidal and bacteriostatic activities of azlocillin and ticarcillin against Pseudomonas aeruginosa.

The activities of azlocillin and ticarcillin against Pseudomonas aeruginosa were compared by estimating minimum inhibitory and bactericidal concentrations (MIC and MBC) in liquid and solid media, and by constructing killing curves from sequential viable counts. In MIC studies, azlocillin was about three times more active than ticarcillin in solid medium (agar dilution test) and in liquid media (tube and microdilution tests). When the MBC was measured, however, results varied according to the technique used. On agar and in microdilution tests, both azlocillin and ticarcillin were bactericidal, the MBC being 1.3-3 MIC. In the tube test, the MBC for ticarcillin was again about 3 MIC, but azlocillin appeared not to be bactericidal (MBC greater than 1 mg/ml). However, sequential viable counts of four clinical isolates showed that at 4 MIC both antibiotics reduced viable counts by a factor of 10(4) in 8 h. Our results stress the importance of methodology when assessing the antibacterial activity of an antibiotic.

Azlocillin↗
PubMed1984

Amoxicillin plus clavulanic acid in the treatment of recurrent urinary tract infections.

Forty-four patients (43 female, 1 male), all with a history of recurrent urinary tract infections, were treated with 250 mg of amoxicillin plus 125 mg of clavulanic acid (one tablet of Augmentin) every 8 h for 7 days. The microbiological cure rates were 84% 1 week after the end of treatment and 67% 1 month later. Side effects, which were reported by 20% of the patients, were mild and in no case caused interruption of treatment. In view of the increasing trend in resistance to agents commonly used for the treatment of urinary tract infections in outpatients, the combination of amoxicillin and clavulanic acid may now be considered a first-line drug in patients with recurrent urinary tract infections.

Adult↗
PubMed1984

Changes in the pharmacokinetics of ciprofloxacin and fecal flora during administration of a 7-day course to human volunteers.

Twelve male subjects, aged 19 to 40 years, shown to be healthy by examination and laboratory tests, took 500 mg of ciprofloxacin every 12 h for 7 days. After the first and the last dose, blood and urine samples were taken and drug concentrations were determined by bioassay. There was a significant buildup in mean concentrations in serum from day 1 to day 7; mean peak levels (attained after 1 to 2 h) were 1.9 and 2.8 micrograms/ml, respectively. The terminal half-life was 3.5 to 4 h. About 40% of the drug was excreted into the urine during the 12-h period after dosing; minimum mean concentrations in urine were 105 micrograms/ml on day 1 and 174 micrograms/ml on day 7. Considerable amounts of ciprofloxacin were found in the feces on day 7 (185 to 2,220 micrograms/g). Marked changes in the aerobic part of the fecal flora were observed as a result of taking ciprofloxacin: coliforms were absent on day 7, and concentrations of streptococci and staphylococci were significantly reduced. There was no overgrowth by yeasts. One week later the fecal flora had returned to a state similar to that found before treatment. Anaerobes were little affected quantitatively but acquired resistance to ciprofloxacin. Side effects were mild and transient.

Adult↗
PubMed1984

Bacteriuria and primary biliary cirrhosis.

Significant bacteriuria was found in 19% of 87 women with primary biliary cirrhosis, whereas in 89 women with other types of chronic liver disease bacteriuria was present in only 7%. In 74 women with rheumatoid arthritis 8% were bacteriuric. Midstream urine specimens obtained from 144 consecutive women with primary biliary cirrhosis attending hospital over a two year period showed that 50 (35%) developed bacteriuria during 12 months of follow up. Bacteriuria was unrelated to age, raised serum bilirubin, drug therapy or urinary pH but was more common in patients with late stage (fibrotic) disease as judged by histological criteria. Fifty seven per cent of bacteriuric primary biliary cirrhosis patients suffered more than one urinary infection. Fifty nine per cent of the 156 bacteriuric episodes were asymptomatic. The types of organism isolated, the antibiotic sensitivity patterns and cure rate were similar to those reported in bacteriuric women without other underlying disease. The reinfection rate (34%), however, was double that reported for bacteriuric episodes in 'problem' women with recurrent bacteriuria, indicating a special susceptibility to urinary infection. The most common isolates were E coli (70%), which did not show abnormal adhesiveness to uroepithelial or buccal cells of normal women, or to those of primary biliary cirrhosis patients. Patients with primary biliary cirrhosis have not been reported to be more susceptible to infection in general. Bacteriuria, however, was common throughout all clinical stages of primary biliary cirrhosis. Thus there may be a unique association between bacteriuria and primary biliary cirrhosis.

Adult↗