Showing papers on "Penicillin published in 1970"
TL;DR: Antibiotics were used most frequently on the pediatric and surgical services, and they were most frequently used without clearly recorded evidence of infection on the surgical services.
Abstract: Between November 1967 and June 1969,24 prevalence studies of nosocomial infections and antibiotic usage were completed in seven community hospitals. Medical records of 5,256 patients were reviewed; 30.6% were receiving antibiotics, and 80% of those were receiving a single agent. Penicillin, ampicillin, and tetracycline use was similar, and these three accounted for about half of the antibiotics given. From January 1968 through June 1969, chloramphenicol use declined sharply; ampicillin and cephalosporin use increased. Antibiotics were used most frequently on the pediatric and surgical services. They were most frequently used without clearly recorded evidence of infection on the surgical services. Fewer than 30% of patients receiving penicillin, sulfonamides, and streptomycin had recorded evidence of infection when the antibiotic was first given; only 38% of 454 patients receiving antibiotics in 1969 had such evidence.
182 citations
TL;DR: Compared with isoxazole penicillins in current clinical use, flucloxacillin has proved as active against Gram-positive cocci, including penicillin-resistant staphylococci, and is well absorbed in man after oral and intramuscular administration.
Abstract: Flucloxacillin, a new isoxazole penicillin, is active against penicillinase-producing strains of Staphylococcus aureus and is well absorbed in man after oral and intramuscular administration. Compared with isoxazole penicillins in current clinical use—namely, oxacillin, cloxacillin, and dicloxacillin—flucloxacillin has proved as active against Gram-positive cocci, including penicillin-resistant staphylococci. The extent of binding of flucloxacillin to the protein of human serum was similar to that of oxacillin and cloxacillin and less than that of dicloxacillin. In man flucloxacillin given orally produced total and free serum levels higher than those obtained with oxacillin and cloxacillin; total serum levels similar to those of dicloxacillin, and free levels greater than those of dicloxacillin. Similarly, after intramuscular injection the free serum levels of flucloxacillin were higher than those of oxacillin, cloxacillin, and dicloxacillin.
174 citations
TL;DR: Not all enterococci show synergism between penicillin and streptomycin or kanamycin, but most patients receive combined therapy empirically since tests for synergy are difficult to perform.
Abstract: Not all enterococci show synergism between penicillin and streptomycin or kanamycin, but most patients receive combined therapy empirically since tests for synergism are difficult to perform. Enterococci showing synergism are considered "resistant" to streptomycin and kanamycin, but usually have not been tested with concentrations higher than 100μ/ml. We had found that strains not showing synergism are actually highly resistant to these antibiotics, in contrast to strains that do show synergism. Of 30 strains where synergism occurred between penicillin G potassium and streptomycin sulfate when killing curves were performed, 27 were inhibited by 250μg/ml. Seventeen strains not showing synergism required 6,000μg/ml or more for inhibition and 11 grew in 50,000μg/ml Forty-four strains showing synergism between penicillin and kanamycin sulfate were inhibited by 250μg/ml or less of kanamycin sulfate, and 5 strains not showing synergism had minimal inhibitory concentrations of 25,000μg/ml or higher.
123 citations
Journal Article•
115 citations
TL;DR: The general surgical literature contains many studies assessing the role of antibiotics in the prevention of wound infections, but the majority of these studies claim that they are ineffective.
Abstract: The general surgical literature contains many studies assessing the role of antibiotics in the prevention of wound infections. The majority of these studies claim that they are ineffective 2,7,13,14 Most studies in tile ortilopaedic literature similarly deny antibiotics an effective role iii preventing postoperative sepsis, audI some authors' results even suggest that their use increases the chance of infection 6, 9,11,12,16,17
102 citations
TL;DR: Although the Public Health Service recommends penicillin as the antibiotic of choice in the treatment of this disease, experts throughout the world generally agree that resistance of Neisseria gonorrhoeae toPenicillin has developed and is continuing to develop.
Abstract: The incidence of gonorrhea continues to rise at an alarming rate. In 1969, the increase was about 13 96, and an estimated minimum of 1,680,000 cases of the disease will occur in the United States in 1970. Thus, gonorrhea continues to be the number one reported bacterial infection in adults. Although the Public Health Service recommends penicillin as the antibiotic of choice in the treatment of this disease, experts throughout the world generally agree that resistance of Neisseria gonorrhoeae to penicillin has developed and is continuing to develop. In 1954, 11 years after the advent of penicillin in the treatment of gonorrhea, in-vitro studies by Love and Finland [1] demonstrated that all of the 106 cultures of gonococci tested were inhibited by 0.06 units/ml or less of penicillin. Two years later, Thayer et al. [2] reported that 22 96 of the gonococcal isolates tested required 0.2 units/ml of penicillin for complete inhibition. Reyn [3] in 1963, after studying susceptibility of the gonococcus to antibiotics in Denmark, stated that 56 96 of the routine cultures were less sensitive to penicillin than those isolated in 1944.
102 citations
TL;DR: The possibility that the particulate d-alanine carboxypeptidase present in Bacillus subtilis may be an uncoupled transpeptid enzyme is discussed.
102 citations
Journal Article•
TL;DR: Ampicillin appears to be the drug of choice and its superiority over symptomatic therapy was statistically significant, and the relative merits of erythromycin and ampicillin require further study.
Abstract: Results of the use of ampicillin, penicillin G and symptomatic therapy in the treatment of acute otitis media in 142 children were compared. Antibiotic therapy conveyed significant benefit. No major differences were observed between penicillin and ampicillin, except in the age group under 3 years where ampicillin was associated with the best results. Ampicillin appears to be the drug of choice. Its superiority over symptomatic therapy was statistically significant. Long-term sequelae were not observed in any of the three treatment groups. The relative merits of erythromycin and ampicillin require further study.
80 citations
67 citations
TL;DR: In this article, a study of the more common, but less well-understood morbilliform eruptions which occur several days to weeks following penicillin therapy was conducted.
61 citations
TL;DR: Intramuscular benzathine penicillin G therapy does provide a means for prompt eradication of streptococci, effective clearing of clinical infection, and limiting the spread of organisms to others.
TL;DR: Evidence is obtained that R factor evolved before the advent of the antibiotic era, and multiple-antibiotic resistance was shown to be due to R factor by serial transfer through several recipients, by the absence of transfer from cell-free filtrates, and by the occurrence of transfer independently of the chromosome.
Abstract: Although the therapeutic use of antibiotics favors the selection of bacteria that contain R factor, it does not necessarily follow that man-made antibiotics have induced the evolution of R factor. We have obtained evidence that R factor evolved before the advent of the antibiotic era. Cultures of fecal flora were taken from 128 people living in an "antibiotic-virgin" community in north Borneo. The total experience of this entire community with antibiotics consisted of 19 injections of penicillin given in 1959 during a yaws-eradication program. Six strains of Escherichia coli isolated from four subjects were found to possess transferable drug resistance. This multiple-antibiotic resistance was shown to be due to R factor by serial transfer through several recipients, by the absence of transfer from cell-free filtrates, and by the occurrence of transfer independently of the chromosome.
TL;DR: The mechanisms responsible for the high levels of the drug in the blood are elucidated, comparisons with other penicillins are made, and dosage regimens that are appropriate for various therapeutic purposes are considered.
Abstract: The high blood levels readily attainable with carbenicillin, especially when it is administered intravenously, are one of the main factors responsible for its efficacy in treatment of infections caused by organisms such as Pseudomonas that are relatively resistant in vitro. The purpose of this paper is to elucidate the mechanisms responsible for the high levels of the drug in the blood, to make comparisons with other penicillins, and to consider dosage regimens that are appropriate for various therapeutic purposes.
TL;DR: It is suggested that streptococcal pyoderma be treated with systemic antibiotic therapy to avoid the complication of renal disease and the absence of glomerulonephritis.
Abstract: Three therapeutic agents were compared in the treatment of 209 children with superficial pyoderma. Patients were given benzathine penicillin G and procaine penicillin G intramuscularly, gentamicin sulfate (Garamycin) topically, or an ointment containing a mixture of antibiotics (Neosporin) topically. In the initial skin culture, 27.2% of the patients had β-hemolytic streptococci, 37.3% had staphylococci, and 35.3% had both organisms present. At one week follow-up, penicillin treatment resulted in a complete bacteriologic cure of patients with streptococci alone, or streptococci and staphylococci combined. Neosporin ointment was less effective than penicillin and gentamicin was the least effective of the three. Staphylococcal pyoderma responded equally well to all three preparations. Despite the absence of glomerulonephritis, we suggest that streptococcal pyoderma be treated with systemic antibiotic therapy to avoid the complication of renal disease.
TL;DR: The moderate in-vitro susceptibility of strains of P. aeruginosa is confirmed and there still remains a need for an anti-Pseudomonas chemotherapeutic agent of greater effectiveness and lower toxicity.
Abstract: ginosa is highly resistant to most antimicrobial agents [2]. Although most strains are sensitive to the polymyxin group of antibiotics in vitro, clinical effectiveness of these drugs in infections of tissue has been disappointing, probably because the polymyxins diffuse poorly into infected tissues [3]. Most clinical isolates of P. aeruginosa are also sensitive to gentamicin, and this antibiotic is now probably the most effective drug for the treatment of infections due to Pseudomonas [4]. However, the clinical dosage and effectiveness of gentamicin is limited by potential toxicity to the kidney and eighth nerve [5], and there still remains a need for an anti-Pseudomonas chemotherapeutic agent of greater effectiveness and lower toxicity. In 1966, Brumfitt, et al. [6] reported that a new penicillin, carbenicillin, was moderately effective in vitro against clinical isolates of P. aeruginosa. Reports from this country have confirmed the moderate in-vitro susceptibility of strains of
TL;DR: In acute otitis media caused by N. catarrhalis, an effect could probably be expected of ampicillin and of penicillin V treatment with daily dosages of 50 mg per kg body weight, and erythromycin would be preferred to oxytetracycline in those instances in which penicillins are contraindicated.
Abstract: The in vitro sensitivity of 108 strains of Neisseria catarrhalis to ampicillin, penicillin G, penicillin V, erythromycin and oxytetracycline was determined. The strains were isolated, inter alia, from ear exudate of children with acute otitis media. Ampicillin was more active than penicillin G, which was followed by erythromycin, penicillin V and oxytetracycline. In acute otitis media caused by N. catarrhalis, an effect could probably be expected of ampicillin and of penicillin V treatment with daily dosages of 50 mg per kg body weight. Erythromycin would be preferred to oxytetracycline in those instances in which penicillins are contraindicated.
TL;DR: Single-dose treatment of asymptomatic gonorrhea was studied in 396 Filipino women hospitalized to prevent reinfections.
Abstract: Single-dose treatment of asymptomatic gonorrhea was studied in 396 Filipino women hospitalized to prevent reinfections. Endocervical cultures were obtained for six days after treatment to detect failures. Failure rates of 13 to 44 per cent were seen with varying doses of a parenteral penicillin G preparation given without probenecid. No failures occurred in 80 patients given 6,000,000 units of parenteral penicillin G with probenecid, or in 108 patients given 3.5 g of ampicillin orally with or without probenecid. These two regimens with probenecid and another with tetracycline were then compared in a prospective program of treatment. After one year, resistance of isolates of Neisseria gonorrhoeae to penicillin and ampicillin was unchanged, but over one third of isolates became resistant to 2 μg per milliliter of tetracycline. The use of penicillin G or of ampicillin, in association with probenecid, is recommended for treatment of women who are infected but have neither acute perineal discomfort no...
TL;DR: The use of aqueous humor assays to determine the intraocular penetration of penicillin G and dihydrostreptomycin is not a valid indication of ocular tissue concentration.
Abstract: The total antibiotic concentration of penicillin G potassium (benzylpenicillin) and dihydrostreptomycin sulfate were determined in the ocular tissues of rabbits by radioactive tracer methods following systemic and subconjunctival administration. Free, unbound active antibiotic concentrations were determined by a modified disk diffusion assay. Both methods correlated well at concentrations greater than 200μg/gm wet tissue, but below this level the free antibiotic concentrations averaged 30% of the total for penicillin G and 75% for dihydrostreptomycin. After both systemic and subconjunctival administration, the free antibiotic levels in all tissues except lens and vitreous exceeded that in aqueous humor. Thus, the use of aqueous humor assays to determine the intraocular penetration of penicillin G and dihydrostreptomycin is not a valid indication of ocular tissue concentration.
TL;DR: Penicillin and semisynthetic penicillins are biologically inactivated by carbohydrate solutions at alkaline pH at 37°C in the presence of sufficient bicarbonate to elevate the pH above 8...
Abstract: Penicillin and semisynthetic penicillins are biologically inactivated by carbohydrate solutions at alkaline pH. At 37°C, in the presence of sufficient bicarbonate to elevate the pH above 8.0, 10 per cent sucrose and 5 per cent glucose cause almost complete inactivation of penicillin within a few hours; inactivation occurs more slowly at room temperature. Semisynthetic penicillins are similarly inactivated. Penicilloic acid appears to be the major product of inactivation. Thus, under clinical conditions in which penicillin is administered in solutions containing both carbohydrate and alkaline buffer, there is risk of losing antibiotic activity and forming allergenic derivatives of penicillin.
TL;DR: The effect of various antibiotics on the rate of hydrolysis of an olive oil emulsion by hog pancreatic lipase was studied by potentiometric titration.
Journal Article•
TL;DR: It has been suggested that partial treatment of bacterial meningitis with low doses of antibiotics can suppress the meningeal reaction sufficiently so that the initial cerebrospinal fluid examination will reveal findings consistent with a viralMeningitis.
TL;DR: This chapter presents a brief review of the history of penicillin over the more than 30-year period from its discovery by Alexander Fleming up to the point where the production of new semisynthetic penicillins has become a routine procedure.
Abstract: Publisher Summary The gateway to the preparation of a virtually limitless list of “semisynthetic” penicillins was not fully opened until isolation of the penicillin “nucleus” 6-aminopenicillanic acid (6-APA). As this fermentation-produced chemical became available in quantity, efforts were directed toward producing structurally modified penicillins having (a) a greater degree of intrinsic activity and a wider spectrum than that possessed by penicillin G, along with acid stability and oral absorbability comparable to that of penicillin V; (b) a low degree of deleterious binding to serum proteins; (c) reduced allergenicity; and (d) resistance to microbial p-lactamases. This chapter considers the extent of success achieved in each of these areas. The chapter also presents, in an effort to better emphasize the significance of some of the improvements attained, a brief review of the history of penicillin over the more than 30-year period from its discovery by Alexander Fleming up to the point where the production of new semisynthetic penicillins has become a routine procedure.
TL;DR: Two infants and one adult with infections due to Listeria monocytogenes received ampicillin as the principal therapeutic agent and recovered without sequelae and careful antibiotic sensitivity studies are indicated for each patient.
TL;DR: In mureins of normal rod-shaped P.mirabilis and its penicillin-induced unstable L-form approximately 33% of the diaminopimelic acid residues participate in peptide crosslinkage.
TL;DR: A new method is described, utilising the reactions of hydrated electrons, to demonstrate that reversible ion binding occurs between a series of penicillins and the proteins, bovine serum albumin and lysozyme.
TL;DR: Cervical specimens from 2,160 consecutive prenatal patients at Michael Reese Hospital were cultured on Thayer-Martin medium, and neisseria gonorrhoeae was isolated from a total of 158 patients, eliminating the organism in 89.8 per cent of the cases.