==================================CMR53================================== 53. Patients who have been treated with strong antibiotics (aminoglycosides) and develop diarrhea while on tube feedings because normal intestinal flora are killed. Treating these patients with lactinex or (lactobacillus acidophilus, or lactobacillus bulgaricus) to restore normal flora and stop the diarrhea. 1 UI - 87091978 AU - Reuman PD ; Duckworth DH ; Smith KL ; Kagan R ; Bucciarelli RL ; Ayoub EM TI - Lack of effect of Lactobacillus on gastrointestinal bacterial colonization in premature infants. AB - Studies were carried out on premature infants in the neonatal intensive care unit to determine the effect of feeding of lactobacilli on colonization of the gastrointestinal tract by antibiotic-resistant gram-negative enteric organisms. Thirty premature infants were matched by birth weight and gestational age, randomized and fed double blind either lactobacilli-containing formula or non-lactobacilli-containing formula within 72 hours of delivery. The two study groups were screened weekly by culture for stool lactobacilli, for gram-negative bacteria and for antibiotic resistance of these bacteria. Lactobacilli were cultured from the stools of 13 of 15 patients receiving lactobacilli and from 3 of 15 patients not receiving lactobacilli (P less than 0.001). Gram-negative enteric organisms were isolated during 40 of the 86 weeks (47%) of hospitalization for patients receiving lactobacilli and during 28 of 57 weeks (49%) for patients not receiving lactobacilli. There was no significant difference between the study groups in the number of resistant organisms or in the proportion of resistant organisms per gram-negative enteric isolates (4 of 40 vs. 0 of 28). These results suggest that facultative gram-negative enteric bacterial colonization, with either total or aminoglycoside-resistant strains, is not decreased by oral feedings of Lactobacillus acidophilus in premature infants. MH - Aminoglycosides/PHARMACODYNAMICS ; Antibiotics/PHARMACODYNAMICS ; Drug Resistance, Microbial ; Feces/MICROBIOLOGY ; Gastrointestinal System/*MICROBIOLOGY ; Gram-Negative Bacteria/ DRUG EFFECTS/*GROWTH & DEVELOPMENT/ISOLATION & PURIFICATION ; Human ; Infant, Newborn ; Infant, Premature/*MICROBIOLOGY ; Lactobacillus Acidophilus/ISOLATION & PURIFICATION/*PHYSIOLOGY SO - Pediatr Infect Dis 1986 Nov-Dec;5(6):663-8 2 UI - 87085429 AU - Lin JH ; Savage DC TI - Genetic transformation of rifampicin resistance in Lactobacillus acidophilus. AB - Lactobacillus acidophilus strain 100-33, originally isolated from swine faeces, was transformed to rifampicin resistance with DNA from spontaneous rifampicin-resistant mutants derived from it. Cells of the recipient strain were treated with lysozyme and mutanolysin, mixed with donor DNA and polyethylene glycol and grown on a regeneration medium overnight. After 48 h incubation, the numbers of rifampicin-resistant cells in the populations of regenerated cells were estimated from numbers of colonies. Efficiency of the lysozyme/mutanolysin treatment (the ratio of the number of osmotically fragile cells after the enzyme treatment to the initial cell number) was about 99%. The regeneration frequency of the enzyme-treated cells varied from 5 to 67%. The transformation frequency varied from about 0.2 X 10(-8) to 8.0 X 10(-8) transformants per regenerated cell per microgram DNA. To our knowledge, this method for genetic transformation is the first to be reported for a Lactobacillus strain. MH - Drug Resistance, Microbial/GENETICS ; DNA, Bacterial/GENETICS ; Lactobacillus Acidophilus/*GENETICS ; *Rifampin ; Support, U.S. Gov't, P.H.S. ; *Transformation, Genetic SO - J Gen Microbiol 1986 Aug;132 ( Pt 8):2107-11 3 UI - 87069371 AU - Sussman JI ; Baron EJ ; Goldberg SM ; Kaplan MH ; Pizzarello RA TI - Clinical manifestations and therapy of Lactobacillus endocarditis: report of a case and review of the literature. AB - A case of Lactobacillus casei endocarditis that occurred on a Carpentier-Edwards porcine valve is reported. A review of the literature, which yielded 23 other reports of endocarditis due to this organism, suggests that Lactobacillus is a rare cause of endocarditis. Typically, it occurs in a patient with preexisting structural heart disease (20 of 24 [83%]) and often with some form of recent dental infection or manipulation (18 of 24 [75%]). Six (25%) of 24 patients died of this infection; however, only one (5%) of 19 who were treated with adequate antimicrobial therapy died. The response to antimicrobial therapy was better in the more recent cases. Of those 18 patients who completed a full course of therapy, seven (39%) experienced a relapse; five of these were cured of their infection with a second course of antimicrobial therapy, which usually included higher doses of intravenous penicillin. Our case represents the second reported case that required surgical intervention for cure. Embolic phenomena occurred in 10 (42%) of 24 cases. Various combinations of antibiotics have been successful in achieving cure; however, at present, high-dose penicillin (greater than 25 million units/day) in combination with an aminoglycoside for a period of six weeks appears to be the optimum therapy. MH - Adult ; Antibiotics/THERAPEUTIC USE ; Aortic Valve ; Bioprosthesis ; Case Report ; Drug Resistance, Microbial ; Drug Therapy, Combination ; Endocarditis, Bacterial/DRUG THERAPY/ *ETIOLOGY ; Heart Valve Prosthesis/*ADVERSE EFFECTS ; Human ; Lactobacillus Casei/*PATHOGENICITY ; Male ; Reoperation ; Review SO - Rev Infect Dis 1986 Sep-Oct;8(5):771-6 4 UI - 87019268 AU - Sullam PM ; Slutkin G ; Gottlieb AB ; Mills J TI - Paromomycin therapy of endemic amebiasis in homosexual men. AB - A prospective evaluation was made of the therapeutic efficacy of paromomycin, an orally administered, nonabsorbable aminoglycoside, in 114 homosexual men with mild-to-moderate (nondysenteric) intestinal amebiasis. All patients received 25-35 mg/kg daily in three divided doses for seven days. Of the 80 patients with gastrointestinal complaints at the onset of therapy, 55 (80%) of 69 were asymptomatic within four to six weeks after completion of treatment; 11 patients were lost to follow-up. Paromomycin produced long-term eradication of intestinal Entameba histolytica infection in 92% of all men evaluated. The rate of microbiologic cure among patients with symptoms at the onset of therapy was comparable to that among asymptomatic individuals. Paromomycin was well tolerated, with mild diarrhea during therapy the only frequent adverse effect (67% of patients). Thus, paromomycin is an effective alternative to conventional multi-drug therapy for intestinal amebiasis, and it has the advantages of low toxicity, brief duration of therapy, and a high rate of patient compliance. MH - Adult ; Aged ; Amebiasis/*DRUG THERAPY ; Diarrhea/CHEMICALLY INDUCED ; Entamoebiasis/*DRUG THERAPY ; *Homosexuality ; Human ; Intestinal Diseases/*DRUG THERAPY ; Male ; Middle Age ; Paromomycin/ADVERSE EFFECTS/*THERAPEUTIC USE ; Support, Non-U.S. Gov't SO - Sex Transm Dis 1986 Jul-Sep;13(3):151-5 5 UI - 86154942 AU - Pradhan A ; Majumdar MK TI - Metabolism of some drugs by intestinal lactobacilli and their toxicological considerations. AB - The bacterial metabolism of three drugs (sulphasalazine, phthalylsulphathiazole and chloramphenicol palmitate) and two dyes (tartrazine and methyl red) has been studied using a resting culture technique. The strains used were isolated intestinal lactobacilli, E. coli and mixed cultures of faeces of mice. As high as 94.3% degradation of sulphasalazine was found with a strain of Lactobacillus acidophilus. The highest degradation of phthalylsulphathiazole and chloramphenicol palmitate was found to be 17.6% and 8%, respectively. A kinetic study was conducted on the rate of degradation of sulphasalazine, phthalylsulphathiazole and methyl red. The toxicological aspects of degradation products in relation to the use of lactobacilli as dietary supplement or therapeutic aid are discussed. MH - Animal ; Azo Compounds/METABOLISM ; Chloramphenicol/ANALOGS & DERIVATIVES/METABOLISM ; Drugs/*METABOLISM ; Escherichia Coli/ METABOLISM ; Intestinal Absorption ; Intestines/*MICROBIOLOGY ; Lactobacillus/*METABOLISM ; Mice ; Salicylazosulfapyridine/ METABOLISM ; Sulfathiazoles/METABOLISM ; Tartrazine/METABOLISM ; Toxicology SO - Acta Pharmacol Toxicol (Copenh) 1986 Jan;58(1):11-5 6 UI - 86321979 AU - Iwata M ; Mada M ; Ishiwa H TI - Protoplast fusion of Lactobacillus fermentum. AB - Tetracycline-resistant (Tetr) erythromycin-resistant (Eryr) fusants of Lactobacillus fermentum 604 carrying a 10-megadalton Tetr plasmid and L. fermentum 605 carrying a 38-megadalton Eryr plasmid were obtained by means of polyethylene glycol-induced protoplast fusion. MH - Drug Resistance, Microbial ; Erythromycin/PHARMACODYNAMICS ; Lactobacillus/DRUG EFFECTS/*GENETICS/ULTRASTRUCTURE ; Protoplasts/ *ULTRASTRUCTURE ; R Factors ; Tetracycline/PHARMACODYNAMICS SO - Appl Environ Microbiol 1986 Aug;52(2):392-3 7 UI - 86315372 AU - Norrby SR TI - Problems in evaluation of adverse reactions to beta-lactam antibiotics. AB - Despite their high degree of safety, beta-lactam agents cause adverse reactions. This article deals with the types of adverse reactions to various beta-lactam agents that have been reported and, especially, with the difficulties involved in monitoring and evaluating these reactions. Comparisons of the results of studies of the same drug carried out in various countries show striking differences in the incidence of adverse effects reported. A reason for this variation is the lack of strict definitions of the events that should be regarded as adverse effects. Only rarely are all the unexpected events occurring in patients in clinical studies reported, but the investigators are allowed to make subjective judgments about which reactions are related to the drug tested and are thus reportable. With such procedures there is an inherent risk of overlooking unexpected adverse effects. Also, in the analysis of laboratory adverse reactions the rule that "one finds what one looks for: applies. It seems obvious that if stricter rules for registration of adverse effects had been applied, the toxic effects of various beta-lactams, such as the nephrotoxicity of cephaloridine and the coagulopathies associated with moxalactam, would have been detected much earlier. MH - Antibiotics, Lactam/*ADVERSE EFFECTS ; Clinical Trials ; Convulsions/CHEMICALLY INDUCED ; Diarrhea/CHEMICALLY INDUCED ; Drug Evaluation ; *Drug Hypersensitivity ; Drug Interactions ; Drug Resistance, Microbial ; False Positive Reactions ; Gastrointestinal System/DRUG EFFECTS ; Hematologic Diseases/ *CHEMICALLY INDUCED ; Human ; Kidney/DRUG EFFECTS ; Liver/DRUG EFFECTS ; Penicillins/ADVERSE EFFECTS ; Prospective Studies ; Review SO - Rev Infect Dis 1986 Jul-Aug;8 Suppl 3:S358-70 8 UI - 86310328 AU - Sarra PG ; Vescovo M ; Fulgoni M TI - Study on crop adhesion genetic determinant in Lactobacillus reuteri. AB - The genetic determinant responsible for adherence in one strain of Lactobacillus reuteri isolated from chicken crop has been investigated. After curing experiments carried out on this strain, a plasmid-free derivative was obtained, resulting unchanged as regards adhesion ability and carbohydrate fermentation pattern, but showing a loss of antibiotic resistances. It is suggested a possible localization on chromosome of adhesion determinant. MH - Adhesiveness ; Animal ; Antibiotics/PHARMACODYNAMICS ; Carbohydrates/METABOLISM ; Chickens ; Crop, Avian/*MICROBIOLOGY ; Drug Resistance, Microbial ; DNA, Bacterial/ANALYSIS ; *Genes, Bacterial ; Lactobacillus/DRUG EFFECTS/*GENETICS/METABOLISM ; Phenotype ; Plasmids ; Support, Non-U.S. Gov't SO - Microbiologica 1986 Jul;9(3):279-85 9 UI - 86277894 AU - Joerger MC ; Klaenhammer TR TI - Characterization and purification of helveticin J and evidence for a chromosomally determined bacteriocin produced by Lactobacillus helveticus 481. AB - Lactobacillus helveticus 481 produced an antimicrobial agent active against five closely related species. The sensitive indicators included L. helveticus 1846 and 1244, L. bulgaricus 1373 and 1489, and L. lactis 970. The antimicrobial compound was active at neutral pH under aerobic or anaerobic conditions, was sensitive to proteolytic enzymes and heat (30 min at 100 degrees C), and demonstrated a bactericidal mode of action against sensitive indicators. These data confirmed that antimicrobial activity of L. helveticus 481 was mediated by a bacteriocin, designated helveticin J. Production of helveticin J was maximized in an anaerobic fermentor held at a constant pH of 5.5. Ultrafiltration experiments on culture supernatants containing the bacteriocin revealed that helveticin J was present as an aggregate with a molecular weight in excess of 300,000. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of helveticin J purified through Sephadex chromatography resolved a 37,000-dalton protein band with bacteriocin activity. L. helveticus 481 was shown to harbor a single 8-megadalton plasmid (pMJ1008). Isolates cured of pMJ1008 were phenotypically identical to plasmid-bearing cells in fermentation patterns, helveticin J activity, and immunity spectra. The data provided evidence for a chromosomal location of helveticin J and host immunity determinants. MH - Bacteriocins/GENETICS/*ISOLATION & PURIFICATION/TOXICITY ; Chromosomes, Bacterial/PHYSIOLOGY ; Heat ; Hydrogen-Ion Concentration ; Lactobacillus/*GENETICS/PATHOGENICITY ; Molecular Weight ; Peptide Hydrolases/DIAGNOSTIC USE ; Plasmids ; Protein Binding ; Support, Non-U.S. Gov't SO - J Bacteriol 1986 Aug;167(2):439-46 10 UI - 86269702 AU - Boston PF ; Gowers E ; Rose AJ TI - Augmentin compared with oxytetracycline for chest infections in general practice. AB - Augmentin and oxytetracycline were compared in the treatment of chest infections in general practice in an investigator-blind study of 748 patients randomly allocated to 7 days' treatment with standard doses of either Augmentin or oxytetracycline. Significantly more patients treated with Augmentin had a good overall response to therapy both at day 7 (P less than 0.001) and at day 14 (P less than 0.01). The differences between treatments were less marked for individual signs and symptoms of lower respiratory tract infections, due to smaller numbers of patients with any particular symptom. Augmentin, however, was significantly more effective than oxytetracycline in the resolution of chest pain at day 7 (P less than 0.025) and cough at day 14 (P less than 0.005). Sputum purulence was also cleared more effectively by Augmentin by day 14 (P less than 0.001). Both treatments were well tolerated, with no significant difference between treatments in the small number of adverse events. Augmentin has been shown to be an effective, well tolerated treatment for chest infections, superior to oxytetracycline in efficacy and possibly in speed of resolution of clinical symptoms. MH - Adolescence ; Adult ; Aged ; Amoxicillin/ADVERSE EFFECTS/ *THERAPEUTIC USE ; Clavulanic Acids/ADVERSE EFFECTS/*THERAPEUTIC USE ; Clinical Trials ; Comparative Study ; Diarrhea/CHEMICALLY INDUCED ; Drug Combinations/ADVERSE EFFECTS/THERAPEUTIC USE ; Human ; Middle Age ; Nausea/CHEMICALLY INDUCED ; Oxytetracycline/ ADVERSE EFFECTS/*THERAPEUTIC USE ; Random Allocation ; Respiratory Tract Infections/*DRUG THERAPY/MICROBIOLOGY ; Sputum/ MICROBIOLOGY SO - Br J Dis Chest 1986 Apr;80(2):148-56 11 UI - 86259309 AU - Congeni BL ; Bradley J ; Hammerschlag MR TI - Safety and efficacy of once daily ceftriaxone for the treatment of bacterial meningitis [published erratum appears in Pediatr Infect Dis 1986 Sep-Oct;5(5):508] AB - Fifty-seven patients with bacterial meningitis were treated with once daily ceftriaxone. After an initial loading dose of 100 mg/kg, the patients received 80 mg/kg as a single daily dose. Etiologic agents included: Haemophilus influenzae type b, 37 (11 beta-lactamase-positive); Neisseria meningitidis, 11; Streptococcus pneumoniae, 6; Streptococcus pyogenes, 1; Haemophilus influenzae type f, 1; and Group B Streptococcus, 1. All patients showed clinical improvement and all were bacteriologically cured. Satisfactory cerebrospinal fluid bactericidal activity and drug concentrations were seen 24 hours after a dose even in those patients in whom repeat spinal taps were carried out following the last dose of therapy. The drug was well-tolerated and the major adverse effect seen was diarrhea in 20.4% of the patients. The diarrhea was mild and self-limited and did not necessitate discontinuation of the drug although it was frequently associated with alterations in the stool microbiologic flora. Based on this preliminary experience, ceftriaxone, when given in a single daily dose, appears safe and effective in the treatment of bacterial meningitis in nonneonatal infants and children. MH - Bacterial Infections/CEREBROSPINAL FLUID/*DRUG THERAPY/ MICROBIOLOGY ; Ceftriaxone/*ADMINISTRATION & DOSAGE/ADVERSE EFFECTS/CEREBROSPINAL FLUID/THERAPEUTIC USE ; Child ; Child, Preschool ; Diarrhea/CHEMICALLY INDUCED ; Feces/MICROBIOLOGY ; Female ; Haemophilus Influenzae/DRUG EFFECTS ; Human ; Infant ; Infant, Newborn ; Male ; Meningitis/CEREBROSPINAL FLUID/*DRUG THERAPY/MICROBIOLOGY ; Meningitis, Haemophilus/CEREBROSPINAL FLUID/DRUG THERAPY/MICROBIOLOGY ; Meningitis, Meningococcal/ CEREBROSPINAL FLUID/*DRUG THERAPY/MICROBIOLOGY ; Meningitis, Pneumococcal/CEREBROSPINAL FLUID/*DRUG THERAPY/MICROBIOLOGY ; Neisseria Meningitidis/DRUG EFFECTS ; Streptococcus pneumoniae/ DRUG EFFECTS ; Streptococcus Agalactiae/DRUG EFFECTS ; Streptococcus Pyogenes/DRUG EFFECTS SO - Pediatr Infect Dis 1986 May-Jun;5(3):293-7 12 UI - 86254270 AU - Borriello SP ; Barclay FE TI - An in-vitro model of colonisation resistance to Clostridium difficile infection. AB - To investigate the importance of the normal gut flora in preventing the establishment of Clostridium difficile in vivo we have developed an in-vitro test system based on growth in faecal emulsions. Growth of C. difficile and cytotoxin production are inhibited in faecal emulsions from healthy adults, but not in sterilised emulsions; the importance of viable bacteria in the inhibitory system is evident. Generally, faecal emulsions derived from infants, children and geriatric patients were less inhibitory than those from healthy adults. Those from bottle-fed infants were significantly less inhibitory than those from breast-fed infants. Decreased levels of cytotoxin in the latter group were attributed to the acidic pH of the stools. With the different patient groups studied, faecal samples not inhibitory to C. difficile in vitro were obtained from 21% of patients with antibiotic-associated diarrhoea, 33% of those taking antibiotics but who did not have diarrhoea, 18.7% of those with diarrhoea unassociated with antibiotics, and 79% of those with C. difficile-mediated diarrhoea. In some cases inhibition was due to low faecal pH, as in some infants, and in others to other filterable substances. The degree of inhibition could not be linked to specific volatile fatty acids or enzymes. MH - Adolescence ; Adult ; Aged ; Animal ; *Antibiosis ; Antibiotics/ ADVERSE EFFECTS ; Bacterial Toxins/BIOSYNTHESIS ; Cecum/ MICROBIOLOGY ; Child ; Child, Preschool ; Clostridium/*GROWTH & DEVELOPMENT/METABOLISM ; Clostridium Infections/*MICROBIOLOGY ; Comparative Study ; Diarrhea/CHEMICALLY INDUCED/*MICROBIOLOGY ; Emulsions ; Enterocolitis, Pseudomembranous/MICROBIOLOGY ; Feces/ *MICROBIOLOGY ; Hamsters ; Human ; Infant ; Infant, Newborn ; Middle Age SO - J Med Microbiol 1986 Jun;21(4):299-309 13 UI - 86253326 AU - Moertel CG ; Rubin J ; O'Connell MJ ; Schutt AJ ; Wieand HS TI - A phase II study of combined 5-fluorouracil, doxorubicin, and cisplatin in the treatment of advanced upper gastrointestinal adenocarcinomas. AB - In a phase II study of 67 patients with upper gastrointestinal carcinomas and measurable disease without previous chemotherapy, we have evaluated the combination of intensive course 5-fluorouracil (5-FU) (300 mg/m2/d for five days) doxorubicin (40 mg/m2 on day 1), and cisplatin (60 mg/m2 on day 1). Courses were repeated every 5 weeks. Among 26 patients with gastric carcinoma, a 50% regression rate was obtained with a median survival for all patients of 9 months. Among 29 patients with pancreatic carcinoma, the regression rate was 21% and the median survival was 4 months. Regressions were also observed in smaller numbers of patients with carcinomas of the gallbladder and ampulla of Vater, as well as in cholangiocellular carcinoma of the liver. Toxic reactions were usually clinically tolerable and consisted primarily of nausea, vomiting, stomatitis, diarrhea, leukopenia, and alopecia. Phase III studies are in progress to place the value of this experimental regimen into clinical perspective. MH - Adenocarcinoma/*DRUG THERAPY ; Adult ; Aged ; Antineoplastic Agents, Combined/ADVERSE EFFECTS/*THERAPEUTIC USE ; Cisplatin/ ADMINISTRATION & DOSAGE ; Diarrhea/CHEMICALLY INDUCED ; Doxorubicin/ADMINISTRATION & DOSAGE ; Drug Evaluation ; Female ; Fluorouracil/ADMINISTRATION & DOSAGE ; Gastrointestinal Neoplasms/ *DRUG THERAPY ; Hepatoma/DRUG THERAPY ; Human ; Leukopenia/ CHEMICALLY INDUCED ; Liver Neoplasms/DRUG THERAPY ; Male ; Middle Age ; Pancreatic Neoplasms/DRUG THERAPY/MORTALITY ; Stomach Neoplasms/DRUG THERAPY/MORTALITY ; Stomatitis/CHEMICALLY INDUCED ; Support, U.S. Gov't, P.H.S. ; Thrombocytopenia/CHEMICALLY INDUCED SO - J Clin Oncol 1986 Jul;4(7):1053-7 14 UI - 86240384 AU - Rollin RE ; Mero KN ; Kozisek PB ; Phillips RW TI - Diarrhea and malabsorption in calves associated with therapeutic doses of antibiotics: absorptive and clinical changes. AB - Of 28 healthy, nondiarrheal, colostrum-fed neonatal calves, 22 developed diarrhea after they were given (orally) for 3 to 5 days maximally recommended doses of chloramphenicol, neomycin, ampicillin, or tetracycline. Ampicillin-, neomycin-, or tetracycline-treated calves had significantly (P less than 0.05) decreased and delayed glucose absorption during oral glucose tolerance tests. Chloramphenicol-treated calves had significantly (P less than 0.05) higher base-line plasma glucose concentrations during the non-test period and had no significant increase in blood glucose concentrations during the tolerance tests compared with those in control calves. MH - Ampicillin/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS ; Animal ; Antibiotics/ADMINISTRATION & DOSAGE/*ADVERSE EFFECTS ; Blood Glucose/ANALYSIS ; Blood Proteins/ANALYSIS ; Cattle ; Cattle Diseases/*CHEMICALLY INDUCED ; Chloramphenicol/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS ; Comparative Study ; Diarrhea/CHEMICALLY INDUCED/*VETERINARY ; Glucose Tolerance Test/VETERINARY ; Hematocrit/VETERINARY ; Lactates/BLOOD ; Malabsorption Syndromes/ CHEMICALLY INDUCED/*VETERINARY ; Male ; Neomycin/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS ; Potassium/BLOOD ; Sodium/BLOOD ; Support, U.S. Gov't, Non-P.H.S. ; Tetracycline/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS SO - Am J Vet Res 1986 May;47(5):987-91 15 UI - 86223616 AU - Pressler T ; Pedersen SS ; Christiansen L ; Szaff M ; Koch C ; H:iby N TI - Sultamicillin--a new antibiotic in the treatment of persistent lower respiratory tract infections caused by Haemophilus influenzae. AB - Haemophilus influenzae is a frequent cause of recurrent or chronic lower respiratory tract infections in patients suffering from cystic fibrosis (CF) and other chronic obstructive pulmonary disease (COPD). Ampicillin and its derivatives are routinely used in treatment, but resistant strains producing beta-lactamase frequently necessitate the use of other antibiotics. Sultamicillin is a compound agent for oral use in which ampicillin and the beta-lactamase inhibitor sulbactam are linked as a double ester. This combination is active in vitro against many beta-lactamase producing bacteria including ampicillin-resistant H. influenzae. Eight CF children and ten children with other COPD suffering from chronic or recurrent H. influenzae infection of the lower respiratory tract were treated with sultamicillin orally, 25 mg/kg, 12-hourly, for two weeks. Nine infections were caused by ampicillin-resistant strains. At the end of the treatment 65% of the patients were free of H. influenzae. The only adverse reaction was diarrhoea which occurred in 14 patients, and necessitated withdrawal of one patient from the study. MH - Adolescence ; Ampicillin/ADVERSE EFFECTS/BLOOD/*THERAPEUTIC USE ; Child ; Child, Preschool ; Cystic Fibrosis/*COMPLICATIONS ; Diarrhea/CHEMICALLY INDUCED ; Drug Combinations/ADVERSE EFFECTS/ BLOOD/THERAPEUTIC USE ; Female ; Haemophilus Infections/*DRUG THERAPY/ETIOLOGY ; Haemophilus Influenzae ; Human ; Lung Diseases, Obstructive/*COMPLICATIONS ; Male ; Penicillanic Acids/ ADVERSE EFFECTS/BLOOD/*THERAPEUTIC USE ; Pneumonia/*DRUG THERAPY/ ETIOLOGY SO - J Antimicrob Chemother 1986 Apr;17(4):529-33 USER: 16 UI - 86219477 AU - Fraschini F ; Braga PC ; Falchi M ; Gattei G ; Scaglione F ; Scarpazza G ; Esposti D TI - Ceftriaxone therapy in otolaryngological and pulmonary infections. AB - The efficacy of ceftriaxone, 1 g given intramuscularly once daily, was evaluated in 38 patients with pneumonia (n = 11), pulmonary empyema (n = 2), bronchitis (n = 4), tonsillitis (n = 9), sinusitis (n = 7), and otitis (n = 5). Causative organisms were Streptococcus pneumoniae (n = 11), viridans type streptococcus (n = 1), Haemophilus influenzae (n = 6), group A streptococcus (n = 10), Staphylococcus aureus (n = 3), Klebsiella pneumoniae (n = 2), Pseudomonas aeruginosa (n = 1), Escherichia coli (n = 2), Proteus mirabilis (n = 1), and Proteus vulgaris (n = 1). Sterilization of infected foci was obtained in 89.4% of those treated, with clinical recovery in 86.8%. The ceftriaxone regimen was well tolerated. MH - Adolescence ; Adult ; Aged ; Ceftriaxone/ADMINISTRATION & DOSAGE/ ADVERSE EFFECTS/*THERAPEUTIC USE ; Child ; Diarrhea/CHEMICALLY INDUCED ; Drug Administration Schedule ; Female ; Human ; Male ; Middle Age ; Otitis/*DRUG THERAPY ; Respiratory Tract Infections/ *DRUG THERAPY ; Tonsillitis/*DRUG THERAPY SO - Chemotherapy 1986;32(3):200-4 17 UI - 86198021 AU - Davies AJ ; James PA ; Hawkey PM TI - Lactobacillus endocarditis. AB - Two cases of endocarditis due to Lactobacillus plantarum and Lactobacillus casei var. rhamnosus are described. Both patients were successfully treated medically. The response of the two isolates to a range of concentrations of penicillin in an apparatus which continuously monitored growth is reported. The strain of L. casei var. rhamnosus was found to be penicillin tolerant. The use of a combination of a penicillin with gentamicin to treat endocarditis due to penicillin tolerant strains of lactobacillus is discussed. The criteria for selecting oral agents to follow intravenous therapy are assessed also. MH - Adult ; Amoxicillin/BLOOD/THERAPEUTIC USE ; Case Report ; Drug Resistance, Microbial ; Drug Therapy, Combination ; Drug Tolerance ; Endocarditis, Bacterial/DRUG THERAPY/*MICROBIOLOGY ; Gentamicins/BLOOD/THERAPEUTIC USE ; Human ; Lactobacillus/*DRUG EFFECTS/ISOLATION & PURIFICATION ; Lactobacillus Casei/*DRUG EFFECTS/ISOLATION & PURIFICATION ; Male ; Microbial Sensitivity Tests ; Middle Age ; Penicillins/BLOOD/*PHARMACODYNAMICS/ THERAPEUTIC USE ; Rifampin/BLOOD/THERAPEUTIC USE SO - J Infect 1986 Mar;12(2):169-74 18 UI - 86141027 AU - Gammon WR ; Meyer C ; Lantis S ; Shenefelt P ; Reizner G ; Cripps DJ TI - Comparative efficacy of oral erythromycin versus oral tetracycline in the treatment of acne vulgaris. A double-blind study. AB - The efficacy of erythromycin base (E-Mycin tablets, 333 mg) and the efficacy of tetracycline hydrochloride (Panmycin tablets) were compared in this double-blind, randomized study. Two hundred patients with moderate to moderately severe acne vulgaris were randomly assigned to the study. One hundred patients received 1 gm of erythromycin base by mouth per day for 4 weeks, followed by 333 mg/day for 8 weeks, plus placebo for tetracycline. The second group of patients received 1 gm of tetracycline by mouth per day for 4 weeks, followed by 500 mg/day for 8 weeks, plus placebo for erythromycin. Both drugs reduced acne severity to the same extent. Pustules, papules, and open comedo counts decreased significantly over the 12-week period. Seventy-seven percent of the erythromycin-treated patients and 89% of the tetracycline-treated patients stated that their acne was markedly improved or improved by week 12. Most of the side effects in patients treated with erythromycin were gastrointestinal symptoms. Among the side effects in patients treated with tetracycline were Candida vaginitis in one patient and pseudotumor cerebri in one patient. MH - Acne/*DRUG THERAPY ; Administration, Oral ; Adolescence ; Adult ; Clinical Trials ; Comparative Study ; Diarrhea/CHEMICALLY INDUCED ; Double-Blind Method ; Erythromycin/ADMINISTRATION & DOSAGE/ ADVERSE EFFECTS/*THERAPEUTIC USE ; Female ; Human ; Nausea/ CHEMICALLY INDUCED ; Pregnancy ; Support, Non-U.S. Gov't ; Tetracycline/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS/*THERAPEUTIC USE SO - J Am Acad Dermatol 1986 Feb;14(2 Pt 1):183-6 19 UI - 86120643 AU - Kaleida PH ; Bluestone CD ; Blatter MM ; Reisinger KS ; Wucher FP ; Fall PA ; Rohn DD TI - Sultamicillin (ampicillin-sulbactam) in the treatment of acute otitis media in children. AB - Sultamicillin, a dimer of ampicillin and a beta-lactamase-inhibiting agent, sulbactam, was given in oral form to 50 infants and children with acute otitis media. Tympanocentesis was performed on entry into the trial. Beta-lactamase-positive Haemophilus influenzae or Branhamella catarrhalis was isolated from 14 of 73 (19.2%) middle ear effusions in 9 children. Relief of symptoms (fever/otalgia) occurred in all children who completed therapy. However, in 8 children (16%), the antimicrobial agent was discontinued due to presumed adverse side effects (primarily gastrointestinal); vomiting which began prior to entry was noted in another subject who was withdrawn. An additional 14 children completed the course of treatment despite having diarrhea. Of the 41 children who completed drug therapy, 11 (26.8%) were effusion-free after 10 days, and 22 of 33 (66.7%) evaluable children were effusion-free after 6 weeks. Sultamicillin is a novel therapeutic approach to beta-lactamase-producing bacteria. In its oral form, however, diarrhea is a troublesome side effect. MH - Ampicillin/ADVERSE EFFECTS/*THERAPEUTIC USE ; Child ; Child, Preschool ; Diarrhea/CHEMICALLY INDUCED ; Drug Combinations/ ADVERSE EFFECTS/THERAPEUTIC USE ; Female ; Human ; Infant ; Male ; Otitis Media/*DRUG THERAPY ; Patient Compliance ; Penicillanic Acids/ADVERSE EFFECTS/*THERAPEUTIC USE ; Penicillin Resistance ; Recurrence ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. SO - Pediatr Infect Dis 1986 Jan-Feb;5(1):33-8 20 UI - 86105539 AU - Hill LV ; Embil JA TI - Vaginitis: current microbiologic and clinical concepts. AB - Infectious vaginitis occurs when the normal vaginal flora is disrupted; it may arise when saprophytes overwhelm the host immune response, when pathogenic organisms are introduced into the vagina or when changes in substrate allow an imbalance of microorganisms to develop. Examples of these types of vaginitis include the presence of chronic fungal infection in women with an inadequate cellular immune response to the yeast, the introduction of trichomonads into vaginal epithelium that has a sufficient supply of glycogen, and the alteration in bacterial flora, normally dominated by Lactobacillus spp., and its metabolites that is characteristic of "nonspecific vaginitis:. The authors review microbiologic and clinical aspects of the fungal, protozoal and bacterial infections, including the interactions of bacteria thought to produce nonspecific vaginitis, that are now recognized as causing vaginitis. Other causes of vaginitis are also discussed. MH - Antibody Formation ; Antifungal Agents/THERAPEUTIC USE ; Candidiasis/DRUG THERAPY/MICROBIOLOGY/TRANSMISSION ; Candidiasis, Vulvovaginal/DRUG THERAPY/IMMUNOLOGY/OCCURRENCE/TRANSMISSION ; Carrier State/DRUG THERAPY/MICROBIOLOGY ; Female ; Haemophilus vaginalis ; Haemophilus Infections/DIAGNOSIS/DRUG THERAPY/ OCCURRENCE ; Human ; Lactobacillus/ISOLATION & PURIFICATION ; Male ; Metronidazole/THERAPEUTIC USE ; Mycoplasma Infections ; Nystatin/ADMINISTRATION & DOSAGE/THERAPEUTIC USE ; Pregnancy ; Pregnancy Complications, Infectious/IMMUNOLOGY ; Review ; Sex Behavior ; Streptococcal Infections ; Streptococcus Agalactiae ; Support, Non-U.S. Gov't ; Trichomonas Vaginitis/COMPLICATIONS/ DRUG THERAPY/OCCURRENCE/TRANSMISSION ; Vagina/MICROBIOLOGY ; *Vaginitis/ETIOLOGY/OCCURRENCE ; Virus Diseases SO - Can Med Assoc J 1986 Feb 15;134(4):321-31