Subject(s)
Appendix , Cecal Diseases/diagnostic imaging , Emergency Treatment/methods , Ileal Diseases/diagnostic imaging , Intussusception/diagnostic imaging , Abdominal Pain/etiology , Adult , Causality , Cecal Diseases/complications , Cecal Diseases/surgery , Colectomy , Gastrointestinal Hemorrhage , Humans , Ileal Diseases/complications , Ileal Diseases/surgery , Intussusception/complications , Intussusception/surgery , Male , Tomography, X-Ray ComputedABSTRACT
An accurate and sensitive bioassay for determining concentrations of teicoplanin in serum has been developed using modifications of procedures described for assaying vancomycin. A linear relationship (r = 0.9983) was obtained between the diameter of the zone of inhibition and log10 teicoplanin concentration over the range 0.25-32 micrograms/ml. The medium used was Antibiotic Medium No. 1 (Oxoid, UK) adjusted to pH 5.5-5.7 by the addition of hydrochloric acid and containing sodium chloride to a final concentration of 3%. The indicator organism used was a Bacillus subtilis ATCC 6633 (NCTC 10400). Teicoplanin was assayed: (i) in the presence of beta-lactams and cephalosporins, including ceftazidime, by prior treatment of serum with broad-spectrum beta-lactamase mixtures (Genzyme Laboratories, UK); (ii) in the presence of aminoglycosides by prior treatment of serum with cellu-ion phosphate (100 mg/ml) followed by centrifugation; (iii) in the presence of sulphamethoxazole and/or trimethoprim by the addition of p-aminobenzoic acid and/or thymidine to the assay medium. Teicoplanin was assayed in the presence of either rifampicin or erythromycin by using a rifampicin-resistant, erythromycin-resistant clinical isolate of Staphylococcus aureus as indicator organism. The lower limit of sensitivity of this assay was 1 microgram/ml. The presence of undeclared, broad-spectrum antimicrobials was detected by screening serum samples for antimicrobial activity using an assay plate seeded with Escherichia coli NCTC 10418.
Subject(s)
Anti-Bacterial Agents/blood , Anti-Bacterial Agents/pharmacology , Bacillus subtilis/drug effects , Biological Assay/methods , Glycopeptides/blood , Glycopeptides/pharmacology , Humans , Staphylococcus aureus/drug effects , TeicoplaninABSTRACT
Thirty-two episodes of severe infection in 23 patients were treated with parenteral ceftazidime: 96% of the infections were cured or improved. Of 15 chest infections in cystic fibrosis patients, 14 responded satisfactorily to treatment, including 9 cases where Pseudomonas aeruginosa and 7 cases where Staphylococcus aureus was a pathogen. All seven cases of peritonitis in peritoneal dialysis patients were cured or improved. Other infections that responded to treatment were urinary tract infections (3), septicaemias (2), wound infections (2), acute bronchitis (2) and cholangitis (1). Ceftazidime was shown to produce good blood and peritoneal dialysis fluid levels and to penetrate into sputum. Adverse effects were few and not serious.
