ABSTRACT
In 7 patients with bronchopulmonary infections, treatment with penicillin antibiotics failed to eradicate Haemophilus influenzae or Streptococcus pneumoniae which were sensitive to the antibiotic used. The sputum of these patients contained both the pathogen and beta-lactamase-producing Branhamella catarrhalis. No antibacterial activity was detectable in sputum samples obtained from patients receiving a penicillin antibiotic. This suggests that B. catarrhalis can act as an indirect pathogen, protecting accompanying pathogens from antibiotics by producing an antibiotic-destroying enzyme.
Subject(s)
Neisseriaceae/pathogenicity , Respiratory Tract Infections/microbiology , Aged , Anti-Bacterial Agents/therapeutic use , Bronchitis/microbiology , Chronic Disease , Female , Humans , Male , Middle Aged , Sputum/microbiologyABSTRACT
An open study of the use of ceftazidime in patients with Gram-negative infections was undertaken in a district general hospital. Ceftazidime was used in three groups of patients: 17 adults with infections due to Pseudomonas sp. or multi-resistant enterobacteria, three children with cystic fibrosis who had chest infections, and two premature neonates with severe pseudomonal pneumonia. The infections in the adult group included respiratory tract (6), urinary tract (4), wound infection (3), abdominal sepsis (2), osteomyelitis and panophthalmitis. In this group, ceftazidime was given as 1-2 g tid intravenously. In three patients, gentamicin was used concurrently and in four metronidazole was added. 76% of the adult group achieved complete clinical cure, all three cystic fibrosis cases improved markedly, and the two neonates showed complete resolution of the pneumonia. No adverse biochemical or haematological side effects occurred, although one patient developed an urticarial skin rash on the last day of a ten-day treatment course which resolved after discontinuing the ceftazidime.
Subject(s)
Cephalosporins/therapeutic use , Enterobacteriaceae Infections/drug therapy , Infant, Newborn, Diseases/drug therapy , Pseudomonas Infections/drug therapy , Respiratory Tract Infections/drug therapy , Adult , Aged , Ceftazidime , Cystic Fibrosis/complications , Female , Humans , Infant, Newborn , Male , Middle Aged , Osteomyelitis/drug therapy , Urinary Tract Infections/drug therapy , Wound Infection/drug therapyABSTRACT
Three patients with serious infections due to Gram-negative bacilli were treated with ceftazidime: a 52-year-old woman with Enterobacter cloacae meningitis, a 33-year-old woman with post-traumatic Pseudomonas aeruginosa mediastinitis and a 68-year-old man with myelomatosis and Ps. aeruginosa pneumonia. In all three cases the use of ceftazidime, in combination with gentamicin, resulted in clinical improvement associated with rapid clearing of the organism from infected sites. No haematological or biochemical abnormality attributable to ceftazidime was detected.
