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1.
Protein Eng ; 13(12): 857-63, 2000 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-11239085

RESUMO

The binding of penicillin to penicillin acylase was studied by X-ray crystallography. The structure of the enzyme-substrate complex was determined after soaking crystals of an inactive betaN241A penicillin acylase mutant with penicillin G. Binding of the substrate induces a conformational change, in which the side chains of alphaF146 and alphaR145 move away from the active site, which allows the enzyme to accommodate penicillin G. In the resulting structure, the beta-lactam binding site is formed by the side chains of alphaF146 and betaF71, which have van der Waals interactions with the thiazolidine ring of penicillin G and the side chain of alphaR145 that is connected to the carboxylate group of the ligand by means of hydrogen bonding via two water molecules. The backbone oxygen of betaQ23 forms a hydrogen bond with the carbonyl oxygen of the phenylacetic acid moiety through a bridging water molecule. Kinetic studies revealed that the site-directed mutants alphaF146Y, alphaF146A and alphaF146L all show significant changes in their interaction with the beta-lactam substrates as compared with the wild type. The alphaF146Y mutant had the same affinity for 6-aminopenicillanic acid as the wild-type enzyme, but was not able to synthesize penicillin G from phenylacetamide and 6-aminopenicillanic acid. The alphaF146L and alphaF146A enzymes had a 3-5-fold decreased affinity for 6-aminopenicillanic acid, but synthesized penicillin G more efficiently than the wild type. The combined results of the structural and kinetic studies show the importance of alphaF146 in the beta-lactam binding site and provide leads for engineering mutants with improved synthetic properties.


Assuntos
Escherichia coli/enzimologia , Mutagênese Sítio-Dirigida , Penicilina Amidase/metabolismo , Penicilina G/metabolismo , Proteínas Recombinantes/metabolismo , Sítios de Ligação , Domínio Catalítico , Cristalografia por Raios X , Primers do DNA/química , Ligantes , Modelos Moleculares , Conformação Molecular , Mutação , Penicilina Amidase/genética , Reação em Cadeia da Polimerase , Proteínas Recombinantes/isolamento & purificação
2.
Nature ; 401(6754): 721-4, 1999 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-10537113

RESUMO

Isopenicillin N synthase (IPNS), a non-haem iron-dependent oxidase, catalyses the biosynthesis of isopenicillin N (IPN), the precursor of all penicillins and cephalosporins. The key steps in this reaction are the two iron-dioxygen-mediated ring closures of the tripeptide delta-(L-alpha-aminoadipoyl)-L-cysteinyl-D-valine (ACV). It has been proposed that the four-membered beta-lactam ring forms initially, associated with a highly oxidized iron(iv)-oxo (ferryl) moiety, which subsequently mediates closure of the five-membered thiazolidine ring. Here we describe observation of the IPNS reaction in crystals by X-ray crystallography. IPNS Fe2+ substrate crystals were grown anaerobically, exposed to high pressures of oxygen to promote reaction and frozen, and their structures were elucidated by X-ray diffraction. Using the natural substrate ACV, this resulted in the IPNS x Fe2+ x IPN product complex. With the substrate analogue, delta-(L-alpha-aminoadipoyl)-L-cysteinyl-L-S-methylcysteine (ACmC) in the crystal, the reaction cycle was interrupted at the monocyclic stage. These mono- and bicyclic structures support our hypothesis of a two-stage reaction sequence leading to penicillin. Furthermore, the formation of a monocyclic sulphoxide product from ACmC is most simply explained by the interception of a high-valency iron-oxo species.


Assuntos
Oxirredutases/metabolismo , Cristalografia por Raios X , Modelos Moleculares , Oligopeptídeos/metabolismo , Oxirredutases/química , Conformação Proteica
3.
Nature ; 387(6635): 827-30, 1997 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-9194566

RESUMO

The biosynthesis of penicillin and cephalosporin antibiotics in microorganisms requires the formation of the bicyclic nucleus of penicillin. Isopenicillin N synthase (IPNS), a non-haem iron-dependent oxidase, catalyses the reaction of a tripeptide, delta-(L-alpha-aminoadipoyl)-L-cysteinyl-D-valine (ACV), and dioxygen to form isopenicillin N and two water molecules. Mechanistic studies suggest the reaction is initiated by ligation of the substrate thiolate to the iron centre, and proceeds through an enzyme-bound monocyclic intermediate. Here we report the crystal structure of IPNS complexed to ferrous iron and ACV, determined to 1.3 A resolution. Based on the structure, we propose a mechanism for penicillin formation that involves ligation of ACV to the iron centre, creating a vacant iron coordination site into which dioxygen can bind. Subsequently, iron-dioxygen and iron-oxo species remove the requisite hydrogens from ACV without the direct assistance of protein residues. The crystal structure of the complex with the dioxygen analogue, NO and ACV bound to the active-site iron supports this hypothesis.


Assuntos
Compostos Ferrosos/metabolismo , Oligopeptídeos/metabolismo , Oxirredutases/química , Penicilinas/biossíntese , Conformação Proteica , Sítios de Ligação , Cristalografia por Raios X , Compostos Ferrosos/química , Ligação de Hidrogênio , Modelos Moleculares , Oligopeptídeos/química , Oxirredutases/metabolismo , Oxigênio/metabolismo
5.
Curr Opin Struct Biol ; 7(6): 857-64, 1997 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-9434907

RESUMO

Two sequential steps are common to the biosynthesis of all penicillin-derived antibiotics: the reaction of three L-amino acids to give L-delta-(alpha-aminoadipoyl)-L-cysteinyl-D-valine, and the oxidation of this tripeptide to give isopenicillin N. Recent studies on the peptide synthetase and oxidase enzymes responsible for these steps have implications for the mechanisms and structures of related enzymes involved in a range of metabolic processes.


Assuntos
Oxirredutases/química , Penicilinas/biossíntese , Penicillium/enzimologia , Peptídeo Sintases/química , Sítios de Ligação , Ferro/química , Ferro/metabolismo , Modelos Químicos , Modelos Moleculares , Oxirredutases/metabolismo , Peptídeo Sintases/metabolismo
6.
Eur J Biochem ; 242(2): 327-31, 1996 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-8973651

RESUMO

Under certain growth conditions the sulfate-reducing bacterium Desulfovibrio gigas forms electron-dense granules in the cells which had been claimed to consist of a magnesium triphosphate). We observed granules after cultivation in media with a low Fe2+ or NH4+ concentration and reinvestigated the nature of the electron-dense bodies. Energy-dispersive X-ray analysis of the granules in the cells showed that they contain large amounts of P, Mg, and K. Gel electrophoresis and chromatographic analyses of isolated granules which had been dissolved in 20 mM EDTA, however, revealed discrepancies with commercially available polyphosphates. 31P-NMR spectra also lacked the peaks in the -22-ppm region which are characteristic for inner phosphates of polyphosphates confirming that the phosphocompound as isolated from the electron-dense bodies of D. gigas did not consist of polyphosphates. Using multinuclear NMR spectroscopy we showed that the electron-dense bodies of D. gigas contained a novel metabolite which was identified as alpha-glucose 1,2,3,4,6-pentakis(diphosphate).


Assuntos
Grânulos Citoplasmáticos/química , Grânulos Citoplasmáticos/ultraestrutura , Desulfovibrio/química , Desulfovibrio/ultraestrutura , Glucose/análise , Polifosfatos/análise , Amônia , Desulfovibrio/crescimento & desenvolvimento , Microanálise por Sonda Eletrônica , Glucose/análogos & derivados , Ferro , Espectroscopia de Ressonância Magnética , Microscopia Eletrônica
7.
Eur J Biochem ; 242(3): 736-40, 1996 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-9022704

RESUMO

Isopenicillin N synthase (IPNS) was cocrystallised with ferrous sulphate and its substrate, delta-(L-alpha-aminoadipoyl)-L-cysteinyl-D-valine (Aad-Cys-Val). Vital to the successful procedure was the maintenance of a rigorously anaerobic environment. Hanging-drop vapour-diffusion crystallisation experiments, using lithium sulphate as the precipitant produced three crystal forms. Form I crystals, with a plate habit, diffracted X-rays to at least 0.11-nm resolution at the European Synchrotron Radiation Facility and belong to the space group P2(1)2(1)2(1), with unit-cell dimensions a = 4.68, b = 7.15, c = 10.10 nm. Their asymmetric unit contains a single IPNS.Fe(II).Aad-Cys-Val complex with a solvent content of 38.5%. Form II crystals, with a hexagonal habit, diffract X-rays to at least 0.21 nm resolution at the European Synchrotron Radiation Facility and belong to the space group P3(1)21, with unit-cell dimensions a = 10.10, b = 10.10, c = 11.567 nm. Their asymmetric unit also contains a single IPNS.Fe(II).Aad-Cys-Val complex with a solvent content of 69.5%. Form III crystals, needles, do not show well-ordered diffraction. Although all three forms were initially produced in crystallisation experiments under identical conditions, appropriate micro and streak seeding allows selective crystallisation of form I or form II crystals. Extended X-ray-absorption fine-structure studies on a crystalline slurry of the form I crystals demonstrate the presence of an Fe-S(Aad-Cys-Val) bond length of 0.234 +/- 0.003 nm.


Assuntos
Oxirredutases/ultraestrutura , Anaerobiose , Aspergillus nidulans/enzimologia , Cristalografia por Raios X , Compostos Ferrosos , Ligantes , Oligopeptídeos/química , Proteínas Recombinantes , Análise Espectral
8.
J Bacteriol ; 177(21): 6195-200, 1995 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-7592385

RESUMO

Desulfovibrio gigas NCIMB 9332 cells grown in ethanol-containing medium with 0.1 microM tungstate contained a benzylviologen-linked aldehyde oxidoreductase. The enzyme was purified to electrophoretic homogeneity and found to be a homodimer with a subunit M(r) of 62,000. It contained 0.68 +/- 0.08 W, 4.8 Fe, and 3.2 +/- 0.2 labile S per subunit. After acid iodine oxidation of the purified enzyme, a fluorescence spectrum typical for form A of molybdopterin was obtained. Acetaldehyde, propionaldehyde, and benzaldehyde were excellent substrates, with apparent Km values of 12.5, 10.8, and 20 microM, respectively. The natural electron acceptor is not yet known; benzylviologen was used as an artificial electron acceptor (apparent Km, 0.55 mM). The enzyme was activated by potassium ions and strongly inhibited by cyanide, arsenite, and iodoacetate. In the as-isolated enzyme, electron paramagnetic resonance studies readily detected W(V) as a complex signal with g values in the range of 1.84 to 1.97. The dithionite-reduced enzyme exhibited a broad signal at low temperature with g = 2.04 and 1.92; this is indicative of a [4Fe-4S]1+ cluster interacting with a second paramagnet, possibly the S = 1 system of W(IV). Until now W-containing aldehyde oxidoreductases had only been found in two Clostridium strains and two hyperthermophilic archaea. The D. gigas enzyme is the first example of such an enzyme in a gram-negative bacterium.


Assuntos
Aldeído Oxirredutases/metabolismo , Benzil Viologênio/metabolismo , Coenzimas , Desulfovibrio/enzimologia , Molibdênio/análise , Tungstênio/análise , Aldeído Oxirredutases/antagonistas & inibidores , Aldeído Oxirredutases/química , Aldeído Oxirredutases/classificação , Sequência de Aminoácidos , Anaerobiose , Espectroscopia de Ressonância de Spin Eletrônica , Transporte de Elétrons , Inibidores Enzimáticos/farmacologia , Metaloproteínas/análise , Dados de Sequência Molecular , Peso Molecular , Cofatores de Molibdênio , Conformação Proteica , Pteridinas/análise , Análise de Sequência , Espectrometria de Fluorescência , Especificidade por Substrato , Enxofre/análise
9.
J Bacteriol ; 175(10): 2859-63, 1993 May.
Artigo em Inglês | MEDLINE | ID: mdl-8491707

RESUMO

A NAD-dependent, oxygen-labile alcohol dehydrogenase was purified from Desulfovibrio gigas. It was decameric, with subunits of M(r) 43,000. The best substrates were ethanol (Km, 0.15 mM) and 1-propanol (Km, 0.28 mM). N-terminal amino acid sequence analysis showed that the enzyme belongs to the same family of alcohol dehydrogenases as Zymomonas mobilis ADH2 and Bacillus methanolicus MDH.


Assuntos
Álcool Desidrogenase/fisiologia , Desulfovibrio/enzimologia , Álcool Desidrogenase/efeitos dos fármacos , Álcool Desidrogenase/isolamento & purificação , Álcool Desidrogenase/ultraestrutura , Sequência de Aminoácidos , Dados de Sequência Molecular , Oxigênio/farmacologia , Homologia de Sequência de Aminoácidos
10.
Biochim Biophys Acta ; 1073(1): 77-84, 1991 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-1991149

RESUMO

5,10-Methylenetetrahydromethanopterin dehydrogenase from Methanobacterium thermoautotrophicum strain delta H was purified to homogeneity with nearly complete recovery. The aerobically stable monofunctional enzyme catalyzed the reversible oxidation of 5,10-methylene-5,6,7,8-tetrahydromethanopterin to its 5,10-methenyl derivative. For the reaction a midpoint potential E'0 = - 362 mV was calculated at 60 degrees C. The methanogenic electron carrier coenzyme F420 was strictly required as the co-substrate. The dehydrogenase (Mr 216,000) was purified as an apparent hexamer of six identical 36 kDa subunits. Oxidation of 5,10-methylenetetrahydromethanopterin coupled to coenzyme F420 reduction catalyzed by the dehydrogenase with a turnover number of 2400 S-1 proceeded via a ternary complex mechanism. High concentrations of monovalent cations markedly stimulated the reaction.


Assuntos
Euryarchaeota/enzimologia , Oxirredutases atuantes sobre Doadores de Grupo CH-NH/isolamento & purificação , Cinética , Peso Molecular , Oxirredutases atuantes sobre Doadores de Grupo CH-NH/química , Oxirredutases atuantes sobre Doadores de Grupo CH-NH/metabolismo , Riboflavina/análogos & derivados , Riboflavina/metabolismo , Especificidade por Substrato
11.
J Bacteriol ; 172(2): 564-71, 1990 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-2298699

RESUMO

The 5,10-methenyltetrahydromethanopterin cyclohydrolase from Methanosarcina barkeri was purified 313-fold to a specific activity of 470 mumol min-1 mg-1 at 37 degrees C and pH 7.8. At this stage, the enzyme was pure as judged from polyacrylamide gel electrophoresis. The monofunctional enzyme was oxygen stable, but the presence of a detergent proved to be essential for its stability. Like the cyclohydrolase purified from Methanobacterium thermoautotrophicum (A. A. Dimarco, M. I. Donnelly, and R. S. Wolfe, J. Bacteriol. 168:1372-1377, 1986), the protein showed an apparent Mr of 82,000, and it is composed of two identical subunits as was concluded from nondenaturating and denaturating polyacrylamide gel electrophoresis. The enzymes from M. thermoautotrophicum and M. barkeri markedly differ with respect to the hydrolysis product of 5,10-methenyltetrahydromethanopterin: 5-formyl- and 10-formyltetrahydromethanopterin, respectively. The apparent Km for 5,10-methenyltetrahydromethanopterin was 0.57 mM at 37 degrees C and pH 7.8.


Assuntos
Aminoidrolases/isolamento & purificação , Euryarchaeota/enzimologia , Aminoidrolases/metabolismo , Cromatografia Líquida de Alta Pressão , Cromatografia por Troca Iônica , Cromatografia em Camada Fina , Eletroforese em Gel de Poliacrilamida , Concentração de Íons de Hidrogênio , Indicadores e Reagentes , Cinética , Peso Molecular , Termodinâmica
12.
J Biol Chem ; 265(4): 1852-7, 1990 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-2298726

RESUMO

5,10-Methylenetetrahydromethanopterin reductase was purified 22-fold to apparent homogeneity from the methanogenic bacterium Methanobacterium thermoautotrophicum. The enzyme catalyzes the reduction of 5,10-methylene- to 5-methyltetrahydromethanopterin. The electron carrier coenzyme F420 is specifically used as the cosubstrate. The reductase reaction may proceed in both directions, methylene reduction is, however, thermodynamically favored. In addition, the velocity of the reaction in this direction exceeds the reverse reaction by a factor of 26. The reductase is composed of a single subunit with an estimated Mr = 35,000. The active enzyme does not contain a flavin prosthetic group or iron-sulfur clusters, in contrast to 5,10-methylenetetrahydrofolate reductases purified from eukaryotic and eubacterial sources, which catalyze an analogous reaction as the methanogenic reductase.


Assuntos
Euryarchaeota/enzimologia , Oxirredutases atuantes sobre Doadores de Grupo CH-NH/isolamento & purificação , Riboflavina/análogos & derivados , Cromatografia por Troca Iônica , Indicadores e Reagentes , Cinética , Peso Molecular , Oxirredutases atuantes sobre Doadores de Grupo CH-NH/metabolismo , Riboflavina/metabolismo , Especificidade por Substrato
13.
Acta Otorhinolaryngol Belg ; 31(6): 554-65, 1977.
Artigo em Francês | MEDLINE | ID: mdl-596154

RESUMO

The tonsils of 44 operated children were submitted to bacteriological and histological examination. 22 children were given an oral penicillin during 5 days before tonsilectomy. Histological data and bacteriological cultures of pharyngeal exsudate and tonsillar material were very similar in the two groups of treated and non treated patients. These data suggest that, when preventive penicillinic treatment is given, it is worthy to consider the dose, the lasting and the route of administration of the prophylactic antibiotic therapy. Its unreliable activity, and the danger of bacteriemy at the moment of the operation plead for an adequate per-operative antibiotherapy.


Assuntos
Tonsilite/microbiologia , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/microbiologia , Criança , Pré-Escolar , Humanos , Tonsila Palatina/microbiologia , Tonsila Palatina/patologia , Penicilinas/uso terapêutico , Tonsilectomia , Tonsilite/tratamento farmacológico , Tonsilite/patologia , Tonsilite/cirurgia
14.
J Infect Dis ; 134 SUPPL: S433-40, 1976 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-792359

RESUMO

Preliminary results are presented for an ongoing, double-blind, clinical trial, in which the efficacy of amikacin plus penicillin G (Amik-Pen) and amikacin plus carbenicillin (Amik-Carb) is compared in treatment of severe gram-negative infections superimposed on serious underlying disease. All clinical isolates were sensitive to amikacin in vitro (minimal inhibitory concentration, less than 12 mug/ml). Results in 50 patients with cancer and documented gram-negative infection, 29 of which involved septicemia, were analyzed. In the Amik-Pen group, 40% of 15 cases of septicemia responded favorable to therapy, as compared with 86% of 14 cases of septicemia in the Amik-Carb group; this difference is statistically significant (P less than 0.02). When all patients were considered together, the outcome appeared more favorable (1) in infections caused by pathogens sensitive to both antibiotics used then in those caused by organisms sensitive to amikacin only (83% vs. 43%); (2) when the combined antibiotics demonstrated synergy in virto against the offending pathogen than when the combination was nonsynergistic (83% vs. 38%); and (3) when the peak serum antimicrobial dilution titer was larger than or equal to 1:8 than when titers were lower. The results of this study suggest that routine use of an antibiotic combination that has demonstrable in vitro synergy against the offending pathogen should be considered for the treatment of proven or suspected severe infections due to gram-negative bacilli.


Assuntos
Amicacina/administração & dosagem , Infecções Bacterianas/tratamento farmacológico , Carbenicilina/administração & dosagem , Canamicina/análogos & derivados , Penicilina G/administração & dosagem , Sepse/tratamento farmacológico , Amicacina/efeitos adversos , Amicacina/uso terapêutico , Atividade Bactericida do Sangue , Carbenicilina/efeitos adversos , Carbenicilina/uso terapêutico , Ensaios Clínicos como Assunto , Quimioterapia Combinada , Infecções por Enterobacteriaceae/sangue , Infecções por Enterobacteriaceae/tratamento farmacológico , Humanos , Penicilina G/efeitos adversos , Penicilina G/uso terapêutico , Infecções por Pseudomonas/sangue , Infecções por Pseudomonas/tratamento farmacológico , Sepse/sangue
15.
Biomedicine ; 25(1): 11-5, 1976 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-963186

RESUMO

In order to protect granulopenic patients against infections by pathogens from their own digestive tract, large amounts of lactobacilli were given to 5 patients whose intestinal flora had been suppressed by oral antibiotics. In all these cases, lactobacilli failed to prevent spontaneous recolonization of the gastrointestinal tract by enteric bacteria. Six attempts of colonization were made; in spite of the importance of the inoculum administered orally, large numbers of lactobacilli were recovered from stools in only two cases.


Assuntos
Agranulocitose , Intestinos/microbiologia , Lactobacillus , Neutropenia , Idoso , Agranulocitose/microbiologia , Anemia Aplástica/complicações , Antibacterianos/efeitos adversos , Antibacterianos/uso terapêutico , Feminino , Humanos , Leucemia/complicações , Masculino , Pessoa de Meia-Idade , Neutropenia/complicações , Neutropenia/microbiologia
16.
Chest ; 68(3): 302-6, 1975 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-169104

RESUMO

Endotracheal administration of gentamicin has been compared to the endotracheal administration of aminosidin plus polymyxin B as a preventive measure against tracheobronchial infections in 25 and 22 tracheotomized patients respectively who had been admitted to a neurosurgical unit. Both series were comparable as far as underlying disease, duration of hospitalization, surgical therapy. Both regimens were similarly effective from the bacteriologic and clinical points of view. Both regimens were similarly effective in preventing colonization of bronchial secretions by potential pathogens and were associated with a similar frequency of infectious episodes (eight in each group). The use of aminosidin-polymyxin B combination was associated with a lower incidence of emergence of gentamicin resistant strains, but the endotracheal administration of gentamicin was better tolerated than that of the combination. It is concluded that the combination of aminosidin-polymyxin is a useful alternative to gentamicin for the prevention of bronchopulmonary infections in unconscious tracheotomized patients.


Assuntos
Broncopatias/prevenção & controle , Gentamicinas/uso terapêutico , Paromomicina/uso terapêutico , Polimixinas/uso terapêutico , Infecções Respiratórias/prevenção & controle , Doenças da Traqueia/prevenção & controle , Traqueotomia , Adolescente , Adulto , Idoso , Criança , Ensaios Clínicos como Assunto , Coma , Combinação de Medicamentos , Avaliação de Medicamentos , Feminino , Hospitalização , Humanos , Klebsiella/isolamento & purificação , Pneumopatias/prevenção & controle , Masculino , Pessoa de Meia-Idade , Polimixinas/efeitos adversos , Pseudomonas aeruginosa/isolamento & purificação
17.
Antimicrob Agents Chemother ; 7(6): 742-7, 1975 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-1155918

RESUMO

Sisomicin and gentamicin (2 mg/kg) were administered in a random fashion to patients with bacteriuria superimposed on abnormalities of the urinary tract. Cure was achieved in a similar number of patients in both groups, but superinfection and reinfection with resistant microorganisms was more frequent in patients receiving gentamicin. Untoward side effects were not frequent in this series, especially if the serious underlying urological disease of most patients is taken into consideration. The susceptibility of the causative pathogens to the antibiotic administered and the severity of the underlying disease were the most important factors in the outcome.


Assuntos
Antibacterianos/uso terapêutico , Bacteriúria/tratamento farmacológico , Gentamicinas/uso terapêutico , Sisomicina/uso terapêutico , Infecções Urinárias/tratamento farmacológico , Bacteriúria/etiologia , Humanos , Infecções Urinárias/complicações
18.
Antimicrob Agents Chemother ; 7(5): 640-5, 1975 May.
Artigo em Inglês | MEDLINE | ID: mdl-1096809

RESUMO

Three combinations of antibiotics (cephalothin-tobramycin, cephalothin-ticarcillin, and ticarcillin-tobramycin) were administered empirically to 186 patients with cancer who were suspected of having a life-threatening infection. In approximately one-half of these patients, gram-negative infection was documented bacteriologically and consisted of septicemia in 50% of these patients. The three antimicrobial regimens were similarly effective and resulted in a favorable clinical response in approximately 55% of the patients. The administration of the cephalothin-tobramycin combination was associated with a significantly higher frequency of nephrotoxicity than that of the other two regimens.


Assuntos
Antibacterianos/uso terapêutico , Cefalotina/uso terapêutico , Neoplasias/tratamento farmacológico , Penicilinas/uso terapêutico , Ticarcilina/uso terapêutico , Tobramicina/uso terapêutico , Infecções Bacterianas/complicações , Ensaios Clínicos como Assunto , Quimioterapia Combinada , Feminino , Humanos , Rim/efeitos dos fármacos , Masculino , Neoplasias/complicações
19.
J Clin Pharmacol ; 15(4 Pt 1): 252-61, 1975 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-1092723

RESUMO

A preliminary study was conducted with sisomicin, a new aminoglycoside antibiotic. The drug was administered to 40 patients in doses varying from 1.5 to 3.75 mg/kg/day. Sisomicin proved to be an effective therapy in urinary tract infections and to a lesser extent in wound infections caused by gram-negative rods; favorable results have been observed in 91.6% and in 66.6% of the patients presenting these infections. Toxic reactions involving the hearing function, renal function, and general tolerance were infrequent: they occurred in less than 5% of the patients in this series. (However in approximately 22% of the patients, there was a transient appearance of granular casts in the urine.


Assuntos
Antibacterianos/farmacologia , Sisomicina/farmacologia , Bactérias/efeitos dos fármacos , Infecções Bacterianas/tratamento farmacológico , Ensaios Clínicos como Assunto , Resistência Microbiana a Medicamentos , Feminino , Humanos , Masculino , Sisomicina/efeitos adversos , Sisomicina/uso terapêutico
20.
Am J Med Sci ; 269(2): 201-7, 1975.
Artigo em Inglês | MEDLINE | ID: mdl-1146848

RESUMO

Two groups of 38 patients have been treated for staphylococcal infection with either cephaloridine (4 gm daily) or gentamicin (320 mg daily) by the intramuscular route. The rate of favorable clinical response was higher among the patients who received cephaloridine (78.8 per cent) than among those who were treated with gentamicin (60.5 per cent). No death related to the infection occurred in the cephaloridine-treated patients. The mean peak and trough antibacterial activity reached in the serum of the patients after injection of the antibiotics was higher in patients receiving cephaloridine (1/64 and 1/16) than in those treated with gentamicin (1/16 and 1/4). Patients who failed to respond to therapy had often a low antibacterial activity of the serum. These studies suggest that the 1/8 level of bactericidal activity should be attained in the serum one hour after the administration of the antibiotics to allow optimal results in staphylococcal infections.


Assuntos
Cefaloridina/uso terapêutico , Gentamicinas/uso terapêutico , Infecções Estafilocócicas/tratamento farmacológico , Adulto , Idoso , Cefaloridina/farmacologia , Feminino , Gentamicinas/farmacologia , Humanos , Masculino , Pessoa de Meia-Idade , Staphylococcus/efeitos dos fármacos , Fatores de Tempo
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