Acute lower respiratory tract infections in Jeddah

One hundred and five patients with signs and symptoms of acute lower respiratory tract infection were investigated in a prospective study over a period of 1 year. Potential bacterial pathogens were isolated from the sputum of 27% of patients with productive cough; Haemophilus influenzae was the most frequent organism found in 19% of sputum specimens. Antibiotics had already been prescribed for 36-4% of the 66 patients whose urine was examined for antibacterial activity. Appropriate convalescent serum was obtained from 33 patients only, because of lack of compliance. This resulted in detecting two cases of Mycoplasma pneumoniae infection, and two of adenovirus infections. The total leucocyte count in the blood was not helpful in the diagnosis except in the case of leucopenia where it was associated with a negative sputum culture

In-vitro activity of piperacillin, azlocillin, mezlocillin compared with amikacin and gentamicin against enterobacteriaceae and pseudomonas aeruginosa

The in vitro activities of ureidopenicillins, piperacillin, mezlocillin and aziocillin were compared with those of gentamicin and amikacin against a wide range of Gram-negative organisms. Gentamicin and amikacin had similar activity against most organisms except pseudomonas aeruginosa, Pseudomonas spp., Proteus mirabilis and Provedencia spp. for which amikacin was more active. Gentamicin and amikacin were considerably more active than ureidopenicillins against E. coli, Klebsiella and Enterobacter spp. Piperacillin was the most active .of the ureidopenicillins against most strains of Enterobacteriaceae and Pseudomonas aeruginosa. Mezlocillin was less active than piperacillin but more active than aziocillin except against strains of pseudomonas aeruginosa and Proteus mirabilis. Aziocillin and piperacillin were slightly less active against proteus mirabilis than amikacin, but more active than gentamicin. The antipseudomonal activity of piperacillin was substantially higher than that of gentamicin but slightly lower than that of amikacin. These results suggest that amikacin should be used as the drug of choice in the treatment of Gram-negative infections resistant to gentamicin. Piperacillin and aziocillin are suitable alternative agents

Antimicrobial prescribing of University Hospital in Saudi Arabia

A study of antibiotic use at king Abdulaziz University Hospital [KAUH] during November to December 1983 showed that 21% of all patients received antibiotics [32% surgical, 25% paediatrics, 24% obstetrical and gynaecological and 19% of medical patients]. Prophylaxis accounted for 52% of all antimicrobial drugs administered and more than 70% of prophylactic antibiotic courses were prescribed to cover an operative or a non-operative surgical procedure. More than 90% of prophylactic antimicrobial drugs were administered for more than 48h after operation or procedure, suggesting that limiting prophylaxis to the first 24-48h as currently recommended would substantially reduce expenditures for antimicrobial drugs in the hospital. Ampicillin was the most frequently used antibiotic accounting for 39% of prescriptions, followed by ampiclox [13%], gentamicin [11%] metronidazole [9%].and septrin [9%] More than 40% of the patients who were prescribed antibiotics were not bacteriologically investigated and more than 50% of the total antibiotic courses were not indicated or inappropriately administered in terms of drug or dosage