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Proteus species produces toxins and constitutes a causative agent of some chronic and recurrent infections. For the study of haemolytic activity and the production and inhibition kinetics, a total of 140 local isolates were diagnosed and examined by the general biochemical methods, and their ability of haemolysis were tested by both direct and indirect methods utilizing the enrichment procedure for all strains. Two antibiotics, erythromycin and keflex (cephalexin), were tested for the study of haemolysis inhibition and its kinetisc. Rof further study, examples of Proteus species were selected; the new approach was based on mixing procedure between P. aeruginosa (also pyocyanine) and Proteus species for inhibition of haemolytic activity. Spectrophotometric analysis were used parallel to these studies to support quantitatively the observed results as all samples show an absorption centre at 542 +/- 1 nm. Results of such analysis of haemolytic activity and inhibition kinetics are presented.
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L-Keflex is a newly manufactured cephalexin product in order to maintain effective blood level of the drug for a long period of time. The results of the fundamental and clinical studies are as follows: 1. Mean blood levels of the drug after its single oral dose of 1 g in fasting in 22 cases before operations were: 7.19 mcg/ml at 2 hours (peak), 4.35 mcg/ml at 4 hours, 4.21 mcg/ml at 6 hours, 2.47 mcg/ml at 8 hours and 1.81 mcg/ml at 12 hours, respectively. Existence of the drug in blood was observed for a long period of time. 2. The distribution into the tissues of L-Keflex was generally good. The tissue levels in 19 of 22 samples ranged from 1.30 to 18.0 mcg/g, but 3 samples did not detect the drug in the tissues. Tissue level/blood level ratios were 0.19 approximately 2.67. 3. Half of 30 cases with mild dental infections was treated with a daily dose of 1 g with clinical response of 60.0%, and the other half with 2 g was 78.6% in clinical response. The overall efficacy rate was 69.0%. 4. As a side effect of the drug, only one of 52 cases (fundamental 22 cases, clinical 30 cases) complained of edema on both eyelids. No. abnormality was observed in blood finding, hepatic and/or renal function. From the above results, it is considered that L-Keflex is an effective antibiotic product in infections in the field of oral surgery. Also, L-Keflex has an advantage in that its administration frequence (b.i.d) is less than that of regular cephalexin (q.i.d.).
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It was observed that most of the pus specimens received are from females and urine specimens from males. Specimen of pus contains mostly Staph aureus, Urine specimen contain mostly E. coli whereas Pseudomonas pyrogenosa and proteases were also observed in urine, pus, sputum and ascitic/pleural fluids of patients. Among all drugs that were used, Enoxabid, Ceporex were vary sensitive against strains of Staph and Pseudomonas present in specimen. Strains of proteases were resistant against these drugs. Urixin and Septran show mixed action. In comparison of Enoxabid, Ceporex and Ceporexin, Zenocef and Fortum show sensitivity in fewer cases of Staph and E. coli. Mexaquin shows a good sensitivity against Pseudomonas and E. coli. It was observed that Septran, Erythrocine, Vibramycin, Tetracycline, Klaracid and Keflex are not very good acting drugs in infection of urine, pus, sputum and fluids. Finding of a low but definite level of resistance to septran, erythrocine, Vibramycin, Tetracycline, Klaracid and Keflex is important for selection of empiric therapy for infection.
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Spinal epidural abscesses (SEA) are uncommon in children. This paper reported a two-year-old boy who was noted to have neck stiffness, with local tenderness posteriorly. Bacterial meningitis was suspected initially in terms of the finding of the cerebral spinal fluid; antibiotics were prescribed. Three days later another spinal tap was performed because of persistent high fever and irritability. A pus-like material drained out as the needle punctured into the spinal region. A magnetic resonance image (MRI) scan of the spine revealed a SEA, with extensive involvement from the second cervical spine to the lumbosacral spine region. Culture of the pus, as well as the blood and CSF, were positive for Staphylococcus aureus. Because of extensive involvement of the spinal epidural space, the patient was again given antibiotics: Prostaphllin and Amikin intravenously for six weeks instead of laminectomy. Then the oral antibiotic (Keflex) was given to the patient for another three months after the boy was discharged from the hospital. A review of the literature shows the incidence of SEA to be increasing and the bacterial spectra to be broadening because of increasing use of immunosuppressing drugs or antibiotics, and the increase in numbers of immunecompromised patient. The clinical symptoms and signs of the SEA were non-specific, but SEA can be early diagnosed by computurized tomography (CT) scan or MRI scan with caution. The literature suggests that, if the patient's condition fits the criteria for non-surgical treatment, antibiotic therapy is the first choice for preventing the complication of spinal deformity, especially in children.
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The resistance of two biomaterials, one synthetic and one biologic in origin, to deliberate bacterial infection was compared in a dog model of orthopedic soft tissue reconstruction. Twenty-four adult female dogs were randomly divided into two equal groups and a 2.0-cm-round full-thickness defect was created on the lateral surface of the stifle joint, leaving only the synovium and skin intact. The defect was surgically repaired with either Dacron trade mark mesh or a porcine derived extracellular matrix (ECM) scaffold material. The repair site was inoculated with 1 x 10(8) Staphylococcus aureus at the time of surgery and the dogs were survived for 28 days. Results showed a chronic pyogranulomatous inflammatory response at the Dacron trade mark implant sites versus a constructive tissue-remodeling response without residual inflammation at the ECM implant site. Three dogs in the group receiving the Dacron trade mark mesh were treated with Keflex trade mark (500 mg bid x 7 days) for signs of septicemia. A quantitative bacterial count of the implant sites at the time of sacrifice showed 6.52 x 10(5) +/- 1.2 x 10(6) and 6.5 x 10(2) +/- 1.8 x 10(3) bacteria per gram of tissue for the Dacron trade mark and ECM scaffold sites, respectively (P <.03). The ECM implant material was more resistant than the synthetic implant material to persistent infection following deliberate bacterial contamination and the ECM scaffold supported constructive tissue remodeling.
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Selected antibiotic advertisements in medical journals are discussed to illustrate the misleading information that is often disseminated to physicians by the pharmaceutical industry. Laboratory and clinical data are presented to question the validity of selected advertisements which (1) encourage the use of Keflex for severe respiratory infections in children, (2) recommend the use of Keflex for the treatment of bacterial bronchitis, (3) suggest that high tissue penetration is a unique property of Vibramycin, (4) present pooled susceptability data which do not reflect microbial resistance patterns in the patient's hospital, (5) recommend twice-daily administration of Ancef for urinary tract infections but do not clearly state the potential danger of this regimen for other infections, (6) suggest that gentamicin should be given to adults in only two dosage sizes for the treatment of serious Gram-negative infections, and (7) lead the reader to assume that only women need to be treated for Trichomonas infections. It is suggested that as antibiotics are marketed, hospital therapeutics committees should evaluate their advantages and permit formulary additions for only those agents demonstrating increased efficacy, decreased toxicity or decreased cost. Pharmacists who monitor drug therapy can provide information to the physician which will increase his awareness of optimal antibiotic therapy.
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The most frequently prescribed drug products were reviewed for insights into prescribing and dispensing patterns for ambulatory patients. The indications for eight of the "top" drug products were considered to be pharmacologically or therapeutically questionable. The drug products were: tetracycline, systemic; Dimetapp; Empirin Compound with Codeine; Actified; Darvon Compound 65; Darvocet-N; Donnatal; and Keflex. Drug prescribing review and prescriber education are crucially needed, as well as formulary controls when feasible.