Antimicrobial agents and chemotherapy
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Antimicrob. Agents Chemother. · Jan 1984
Randomized Controlled Trial Comparative Study Clinical TrialComparison of ceftriaxone and traditional therapy of bacterial meningitis.
Forty-five children (aged 1 day to 15 years) with bacterial meningitis were randomized to receive either traditional therapy (ampicillin and chloramphenicol or gentamicin, pending sensitivity) or ceftriaxone (100 mg/kg per day in two doses for a minimum of 10 days). The etiological agents involved were similar for the two groups and included Haemophilus influenzae type b, Neisseria meningitidis, Streptococcus pneumoniae, and group B streptococcus. Repeat spinal taps were carried out 24 to 48 h after admission. ⋯ Ceftriaxone was well tolerated; diarrhea, seen in 5 of the 22 patients who received the drug, was the most commonly encountered adverse effect. It was mild, and in no case was it necessary to discontinue the drug. Ceftriaxone appears in this preliminary study to be a safe and acceptable single agent for the treatment of bacterial meningitis in children.
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Antimicrob. Agents Chemother. · Jun 1980
Randomized Controlled Trial Clinical TrialSulfamethoxazole- trimethoprim versus ampicillin in treatment of acute invasive diarrhea in adults.
Twenty-seven Navajo adults with moderate to severe acute inflammatory diarrhea were hospitalized and randomly given ampicillin or sulfamethoxazole-trimethoprim. All patients had invasive diarrhea as defined by sheets of fecal leukocytes, seen on methylene blue wet-slide preparations, and significant clinical symptoms, including postural hypotension from dehydration or fever (temperature greater than 100 degrees F [or 37.8 degrees C]). Patients were followed daily for 5 days in the hospital. ⋯ Three of the eight patients successfully treated with sulfamethoxazole-trimethoprim had ampicillin-resistant organisms. The three patients with ampicillin-resistant organisms who were treated with ampicillin appeared to do less well; one was a clinical and bacteriological failure at 72 h and subsequently improved after sulfamethoxazole-trimethoprim therapy. As predicted by in vitro susceptibility studies and by studies in children, sulfamethoxazole-trimethoprim was highly effective in treating adult patients with shigellosis and appears to be the treatment of choice in areas where ampicillin resistance among Shigella is common.
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Antimicrob. Agents Chemother. · Jun 1979
Randomized Controlled Trial Clinical TrialRelationship between aminoglycoside-induced nephrotoxicity and auditory toxicity.
We have reviewed our data from 391 patients entered into three prospective, double-blind studies of aminoglycosides and evaluated 127 cases to determine whether aminoglycoside-induced auditory toxicity and nephrotoxicity are independent events. The cases selected for evaluation included all patients treated for greater than 3 days (mean, 7.7 days) who had serial creatinine determinations and were able to cooperate with serial bedside audiograms (250 to 8,000 Hz). Patients received either gentamicin, tobramycin, or amikacin. ⋯ The incidence of auditory toxicity in the nephrotoxic group (18.2%) was not significantly different from that in the nonnephrotoxic group (15.2%) (P = 0.75; Fisher exact test). There was no statistical difference between the nephrotoxic and auditory toxic groups in patient age, total dose of aminoglycoside, initial creatinine level, duration of therapy, or concurrent use of furosemide or cephalothin. We conclude that aminoglycoside-induced auditory toxicity and nephrotoxicity are independent events when the drug is administered for approximately 7 days and when aminoglycoside levels are maintained within a predefined range.