D. S. Reeves

In vitro antimicrobial susceptibility of Listeria monocytogenes isolated in the UK and other Listeria species.

The MICs and MBCs of 21 antimicrobial agents were determined for 103 strains ofListeria monocytogenes isolated in the UK and 27 strains of otherListeria species. Ampicillin, penicillin, azlocillin, imipenem, gentamicin, netilmicin, amikacin, erythromycin, rifampicin, trimethoprim, clindamycin and vancomycin had good activity, while cephalothin, chloramphenicol, ciprofloxacin and ofloxacin were less active, and cefuroxime, enoxacin, norfloxacin and fosfomycin were the least active. Tetracycline had good activity against many strains, but the MIC was high for some. Unlike the otherListeria species tested,Listeria ivanovii was susceptible to fosfomycin. Inoculum size and media employed were shown to affect the MBC, tryptose phosphate broth yielding higher MBCs than Mueller-Hinton or Isosensitest broths.

Treatment of bacteriuria in pregnancy with single dose fosfomycin trometamol: a review

SummaryBacteriuria in pregnancy occurs in about one in 20 pregnant women and is usually initially asymptomatic. It is an important marker for acute symptomatic infection (often pyelonephritis) later in pregnancy, which occurs in about one in four bacteriurics. Several considerations surround the antibiotic treatment of the asymptomatic infection; these include a low frequency ofin vitro resistance to the agent used, lack of toxicity to the foetus, a low incidence of gastrointestinal side effects, good compliance and proven efficacy. Fosfomycin trometamol seems to fit these requirements. In three controlled studies (two multicentric) 250 patients were treated with fosfomycin trometamol in a 3 g (as fosfomycin) single dose; 197 patients were given one of three other agents. Cure rates for fosfomycin trometamol were 77–94% (68–94% for other agents), which was satisfactory in an infection which is sometimes difficult to eradicate. Further studies are needed in this important but accessible group of patients. Opportunities should be taken to study more foetal outcomes and provide more data on gastro-intestinal tolerability.ZusammenfassungEine von 20 Frauen entwickelt in der Schwangerschaft eine Bakteriurie, die zunächst asymptomatisch bleibt. Die Bakteriurie ist ein wichtiger prognostischer Marker für eine akute symptomatische Infektion, die häufig als Pyelonephritis im weiteren Schwangerschaftsverlauf (bei einer von vier Frauen mit Bakteriurie) auftritt. Bei der antimikrobiellen Therapie der asymptomatischen Infektion müssen mehrere Gesichtspunkte berücksichtigt werden: die verwendete Substanz sollte eine geringeIn vitro-Resistenz aufweisen, für den Foeten nicht toxisch sein, geringe gastrointestinale Nebenwirkungen haben, gute Compliance sichern und erwiesene Effizienz besitzen. Diese Voraussetzungen scheinen für Fosfomycin Trometamol erfüllt zu sein. In drei kontrollierten (zwei multizentrischen) Studien wurden 250 Patientinnen mit Fosfomycin Trometamol mit einer Einmaldosis von 3 g (als Fosfomycin) behandelt. Bei 197 Patienten wurden drei verschiedene Vergleichssubstanzen eingesetzt. Die Heilungsraten für die mit Fosfomycin Trometamol behandelten Frauen betrugen 77–94% (für die Vergleichssubstanzen 68–94%). Diese Ergebnisse können für eine manchmal schwer eliminierbare Infektion als befriedigend angesehen werden. Weitere Studien in dieser wichtigen Patienten-Gruppe sind erforderlich. Auswirkungen beim Foeten und gastrointestinale Verträglichkeit sollten mehr Beachtung finden.

AVAILABILITY OF THREE ANTIBIOTICS AFTER INTRAMUSCULAR INJECTION INTO THIGH AND BUTTOCK

Abstract The serum levels of cephacetrile, cephaloridine, and gentamicin were measured in healthy volunteers after intramuscular injection into thigh and buttock sites. There were significantly higher peak serum levels of the cephacetrile after thigh injection (vastus lateralis) when compared to a buttock injection (gluteus maximus). A similar trend was apparent after intramuscular gentamicin, although the differences were not significant. Serum levels of cephaloridine showed no significant differences, but urinary recovery of drug was significantly greater after thigh injection.

An open study of the efficacy and safety of single dose fosfomycin trometamol in treatment of hospitalised patients with urinary tract infection (pilot study)

SummarySingle dose fosfomycin trometamol (3 g) was used to treat 20 hospitalised patients with UTI. Tolerance was good or excellent in 19/20 patients; a satisfactory bacteriological outcome was recorded in 11/17 of patients with sensitive organisms and a satisfactory clinical outcome was noted in 12/16 symptomatic individuals.ZusammenfassungZwanzig stationäre Patienten, die an Harnwegsinfektionen litten, wurden mit einer Einmaldosis von 3 g Fosfomycin Trometamol behandelt. 19 der 20 Patienten vertrugen die Medikation ausgezeichnet; das bakteriologische Ergebnis war in 11 von 17 Fällen mit empfindlichem Erregerisolat zufriedenstellend. 12 der 16 symptomatischen Patienten wiesen ein befriedigendes klinisches Ergebnis auf.

LACK OF HOMOGENEITY OF BLADDER URINE

Abstract The concentration of antimicrobial drugs in urine has been found to vary according to which part of micturition was taken. In an experiment designed to investigate this phenomenon, significant lack of homogeneity of bladder urine from volunteers was found in 4 out of 17 micturitions.