Penicillin

About: Penicillin is a research topic. Over the lifetime, 17916 publications have been published within this topic receiving 368480 citations. The topic is also known as: penicillin antibiotic & PCN.

Diagnostic evaluation of a large group of patients with immediate allergy to penicillins: the role of skin testing.

Abstract: Background: Penicillin is no longer the most commonly prescribed β-lactam, and the pattern of reactions has changed. We studied the diagnostic value of skin testing in penicillin-allergic subjects from a population where benzylpenicillin is not now the most frequently used β-lactam. Methods: Patients with a history of immediate allergic reactions to penicillins were studied with: skin tests with major and minor determinants of benzylpenicillin (BPO/MDM), amoxicillin, and ampicillin; in vitro determination of specific IgE; and controlled administration for those with a positive history but negative skin and in vitro tests. A reaction was considered immediate when symptoms appeared within a maximum of 1 h after drug intake. Results: After testing, 290 patients (71% having anaphylaxis and 29% having urticaria) proved to be allergic. Amoxicillin was involved in 64.8% and benzylpenicillin in 2.8% of the patients. Skin test positivity to at least one determinant appeared in 70% of cases, amoxicillin being the most frequent. The overall sensitivity decreased markedly when only BPO and MDM were considered. In 13.1% of patients, the diagnosis was established by in vitro test and in 16.9% by controlled administration. Of the 290 patients, 42.1% were positive to determinants generated from benzylpenicillin and 57.9% were selective responders. Conclusions: Sensitivity of skin tests to BPO was lower than reported, being partly replaced by minor determinants, mostly amoxicillin. The incorporation of additional reagents and the development of new tests are required, and these will probably change as the patterns of consumption vary.

"Continuous" vs. "discontinuous" therapy with penicillin; the effect of the interval between injections on therapeutic efficacy.

Abstract: THERE is a considerable body of experimental evidence that the therapeutic action of penicillin rests in large part on its direct bactericidal action, and that the factor that primarily determines its therapeutic efficacy is the total time for which the drug remains at effective levels at the focus of infection.1 2 3 4 Thus, the number of streptococci or pneumococci surviving in an intramuscular focus in mice after an injection of aqueous sodium penicillin G was found to decrease rapidly only so long as the penicillin remained at effective levels.3 , 4 Extremely large doses, providing concentrations greatly in excess of the effective level, were . . .

Geographic diversity and temporal trends of antimicrobial resistance in Streptococcus pneumoniae in the United States.

Abstract: Resistance of Streptococcus pneumoniae to antibiotics is increasing throughout the United States, with substantial variation among geographic regions. We show that patterns of geographic variation are best explained by the intensity of selection for resistance, which is reflected by differences between the proportions of resistance within individual serotypes, rather than by differences between the frequencies of particular serotypes. Using a mathematical transmission model, we analyzed temporal trends in the proportions of singly and dually resistant organisms and found that pneumococcal strains resistant to both penicillin and erythromycin are increasing faster than strains singly resistant to either. Using the model, we predict that by 1 July 2004, in the absence of a vaccine, 41% of pneumococci at the Centers for Disease Control and Prevention (CDC)'s Active Bacterial Core surveillance (ABCs) sites, taken together, will be dually resistant, with 5% resistant to penicillin only and 5% to erythromycin only.

A review of antibiotic resistance patterns of Streptococcus pneumoniae in Europe.

Abstract: Streptococcus pneumoniae no longer has predictable antibiotic susceptibility There are two areas of high prevalence of resistance (over 25%) to beta-lactam antibiotics in the South-West and North-East of Europe In Spain, a close relationship has been found between the yearly rate of aminopenicillin consumption and penicillin resistance High level resistance (MIC greater than or equal to 1 mg/L) has developed against a previous background of low level resistance The serotypes involved in penicillin resistance in Spain are widespread in other countries Macrolide resistance is high in France (over 15%) and is also increasing in other countries All these resistant isolates remain susceptible to the most recent fluoroquinolones, such as temafloxacin Prospective surveillance, more rational use of antibiotics and a diversification of antibiotic use in respiratory tract infections may serve to limit the threat of antibiotic resistance in S pneumoniae