ABSTRACT
We evaluated single-dose regimens of trimethoprim-sulfamethoxazole, amoxicillin, and cyclacillin as treatment for acute cystitis in 38 women. The trial was prematurely stopped because of frequent treatment failures. At two days after treatment, all 13 patients given trimethoprim-sulfamethoxazole were cured, while four (31%) of 13 given amoxicillin and four (33%) of 12 given cyclacillin had persistent bacteriuria. At two weeks, 11 (85%) of 13 patients given trimethoprim-sulfamethoxazole, six (50%) of 12 given amoxicillin, and three (30%) of ten given cyclacillin were cured. One patient with positive results of antibody-coated bacteria testing who was treated with cyclacillin had signs and symptoms of acute pyelonephritis three days after treatment, and two patients treated with amoxicillin and one treated with trimethoprim-sulfamethoxazole converted antibody-coated bacteria test results from negative to positive after therapy. We conclude that single-dose treatment of cystitis in unselected women with cyclacillin and amoxicillin may result in low cure rates and that progression to acute pyelonephritis may occur following ineffective single-dose therapy.
Subject(s)
Amoxicillin/therapeutic use , Cyclacillin/therapeutic use , Cystitis/drug therapy , Penicillins/therapeutic use , Sulfamethoxazole/therapeutic use , Trimethoprim/therapeutic use , Adolescent , Adult , Amoxicillin/administration & dosage , Amoxicillin/adverse effects , Antibody-Coated Bacteria Test, Urinary , Bacteriuria/drug therapy , Cyclacillin/administration & dosage , Cyclacillin/adverse effects , Cystitis/complications , Drug Administration Schedule , Drug Combinations/administration & dosage , Drug Combinations/adverse effects , Drug Combinations/therapeutic use , Female , Humans , Middle Aged , Pyelonephritis/etiology , Pyuria/drug therapy , Random Allocation , Sulfamethoxazole/administration & dosage , Sulfamethoxazole/adverse effects , Trimethoprim/administration & dosage , Trimethoprim/adverse effects , Trimethoprim, Sulfamethoxazole Drug CombinationABSTRACT
A double-blind study of 240 pediatric outpatients with acute otitis media demonstrated that cyclacillin, administered three times a day for ten days, is as effective as and better tolerated than a similar regimen of amoxicillin. Clinical success was achieved in 96% of the children treated with each drug, and the bacteriologic cure rate was 98% in each treatment group. Only three of the 119 children (2.5%) treated with cyclacillin had drug-related diarrhea, in contrast to 17/121 children (14%) treated with amoxicillin (P less than .01). This greater tolerance for cyclacillin may be due to its more effective and rapid absorption in the upper gastrointestinal tract. The results are discussed in terms of the low incidence of resistant strains of Haemophilus influenzae and the advantages of cyclacillin as the first-line treatment for acute otitis media.
Subject(s)
Amoxicillin/therapeutic use , Bacterial Infections/drug therapy , Cyclacillin/therapeutic use , Otitis Media/drug therapy , Penicillins/therapeutic use , Acute Disease , Amoxicillin/adverse effects , Child , Child, Preschool , Clinical Trials as Topic , Cyclacillin/adverse effects , Double-Blind Method , Female , Humans , MaleABSTRACT
Cyclacillin was used to treat 40 patients with bacterial sinus infections, either acute or exacerbations of chronic infections. The drug was administered orally in a dosage of 500 mg every six hours for ten days, although three patients required extended treatment. More than 70% of the patients had remission of symptoms in six days, and all but the aforementioned three had remission in ten days or less. More than 90% of the patients had a moderate to good response; only two patients had a poor response. The only side effects were gastrointestinal disorders, which disappeared with administration of antacids. No side effects were noted in 72.5% of patients. Cyclacillin proved to be an effective and well-tolerated antibiotic for infections of the paranasal cavities.
Subject(s)
Bacterial Infections/drug therapy , Cyclacillin/therapeutic use , Penicillins/therapeutic use , Sinusitis/drug therapy , Adolescent , Adult , Bacterial Infections/microbiology , Cyclacillin/adverse effects , Digestive System/drug effects , Female , Humans , Male , Middle Aged , Nasal Mucosa/microbiology , Sinusitis/microbiologyABSTRACT
The influences of polymorphisms and pharmacokinetic defects of drug metabolism as causes of toxic drug reactions are presented. The different mechanisms of toxic side effects mediated by alterations of the metabolism and excretion of drugs are discussed.
Subject(s)
Drug-Related Side Effects and Adverse Reactions , Polymorphism, Genetic , Animals , Antipyrine/adverse effects , Cyclacillin/adverse effects , Diazepam/adverse effects , Humans , Kidney Diseases/chemically induced , Pharmacogenetics , Phenylbutazone/adverse effects , Primidone/adverse effects , RatsSubject(s)
Anesthesia, Intravenous/mortality , Cyclacillin/adverse effects , Penicillins/adverse effects , Pentazocine , Substance-Related Disorders , Adolescent , Adult , Aged , Female , Humans , Male , Middle AgedABSTRACT
118 patients of a non specialized intensive care unit have been studied, all of them under high dose bactericidal cover (10 MIU of Na-Penicillin G and 2,0 Ciclacillin q 12 hrs.) for a period of days to 4 weeks. In 17 (14,4%) a skin rash was observed. 10 of these could be studied using special techniques (radial immunodiffusion, passive hemagglutination, RIST and RAST), however in none of these cases there was a hint of the existence of penicillin specific antibodies. In 6 patients also skin tests were performed. There was no immediate type reaction, only twice delayed type reactions occured to Na Pencillin G.6 patients had continuing treatment on spite of the rash and without further steps the effluorescences vanished within 3-6 days. Therefore continuation of the antibiotic therapy in spite of rash along with strict clinical and laboratory monitoring seems to be preferable to a hastened change of antibiotic regime
