Penetration of amoxicillin, cefaclor, erythromycin-sulfisoxazole, and trimethoprim-sulfamethoxazole into the middle ear fluid of patients with chronic serous otitis media.

Penetration into the middle ear of four antibiotics commonly used in treatment of otitis media was studied by administering a single oral dose of amoxicillin, cefaclor, erythromycin-sulfisoxazole, or trimethoprim-sulfamethoxazole to 83 children with chronic serous otitis media. The antibiotic was given 15-240 min before the removal of middle ear fluid (MEF) by ventilation tubes inserted through the tympanic membrane. At the time MEF was obtained, a sample of blood was drawn from the patient, and concentrations of antibiotic in both specimens were assayed either microbiologically by a disk diffusion method or by high-pressure liquid chromatography.

Penetration of ceforanide and cefamandole into the right atrial appendage, pericardial fluid, sternum, and intercostal muscle of patients undergoing open heart surgery.

Doses of 30 mg of ceforanide or cefamandole per kg were administered intravenously to 26 patients just before their chests were opened for coronary artery bypass or cardiac valve replacement surgery. Samples of right atrial appendage, pericardial fluid, plasma, aortic wall, intercostal muscle, and sternum were obtained at different times after the antibiotic was injected, and these samples were assayed for cephalosporin concentration. For ceforanide the pre-bypass plasma half-life was 2.

In vivo inactivation of tobramycin by ticarcillin. A case report.

Inactivation of tobramycin sulfate by ticarcillin disodium was observed in a patient with impaired renal function. Tobramycin elimination half-life was seven hours with concurrent ticarcillin therapy but 35 hours without ticarcillin therapy. The magnitude of change cannot be attributed to changing renal function or tobramycin accumulation.

First and second generation cephalosporins.

Data on tissue levels of drugs are important, for they provide us with information on concentrations that can be achieved at the site of an infection. Yet many questions remain unanswered in this area such as whether it is better to achieve high levels in tissue rapidly as with bolus administration of a drug, or whether it is preferable to maintain levels of drug at lower but more prolonged levels, as with constant infusion administration of a drug. The goal in the future will be to correlate pharmacologic principles with the efficiency of various dosing programs and tissue levels in the clinical setting.

Pharmacokinetics of vancomycin in anuria.

After a single 1-g intravenous dose of vancomycin, the mean peak concentration in the serum of 29 anephric patients was 48.3 micrograms/ml. An initial rapid decline to 15 micrograms/ml within 3-5 hr was followed by slow elimination, with 3.

Training hospital pharmacy technicians: joint effort by departments of education and pharmacy.

The cooperative development and initiation of a one-year pharmacy technician training program is described. The hospital's pharmacy and education departments formulated goals and objectives for the didactic and clinical areas of the program and developed methods to evaluate student competency and the program itself. The training for first class of students consisted of three months of didactic instruction, one month of laboratory experience, and eight months of on-the-job training.

Disopyramide hemodialysis and kinetics in patients requiring long-term hemodialysis.

Disopyramide hemodialysis and kinetics after 200 mg orally in six patients receiving long-term hemodialysis were examined. Mean volume of distribution (area) was 66.5 +/- 13 l.

A comparison of the penetration characteristics of cephapirin and cephalothin into right atrial appendage, muscle, fat, and pericardial fluid of pediatric patients undergoing open-heart operation.

Thirty-two pediatric patients having open-heart operation received a single dose of either cephalothin or cephapirin intravenously, 30 mg per kilogram of body weight, in the operating room, for prophylaxis before the chest cavity was opened. Samples of right atrial appendage, pericardial fluid, muscle, fat, and plasma were obtained at various time intervals after injection of the antibiotics, and assayed for cephalosporin concentration. The concentration-time profiles of cephalothin and cephapirin in atrial appendage, muscle, fat, and plasma were identical.

Effect of protein binding on the penetration of nonmetabolized cephalosporins into atrial appendage and pericardial fluids in open-heart surgical patients.

At various times before surgery, 33 patients undergoing coronary artery bypass or cardiac valve replacement surgery received a single 2.0-g dose of either cefazolin or cephradine. Simultaneous single serum, atrial appendage, and pericardial fluid samples were obtained from the patients at various times and analyzed for drug content.

Penetration characteristics of cefamandole into the right atrial appendage and pericardial fluid in patients undergoing open-heart surgery.

In 24 patients undergoing open-heart operation, 2 gm of cefamandole was administered intravenously by bolus technique at various time intervals prior to operation. Samples of pericardial fluid, atrial appendage tissue, and serum were obtained simultaneously in order to compare antibiotic levels in these sites as a function of time. All samples were microbiologically assayed by disc diffusion.

Penetration of cephapirin and cephalothin into the right atrial appendage and pericardial fluid of patients undergoing open-heart surgery.

To prevent infection in 27 patients who underwent coronary artery bypass or cardiac valve replacement surgery, each patient received a single 2-g dose of either cephalothin or cephapirin intravenously before the operation (prior to opening of the chest cavity). Samples of the right atrial appendage, pericardial fluid, and serum were obtained at various intervals after injection of the antibiotic and were assayed for cephalosporin concentrations. Cephapirin consistently reached higher levels than cephalothin in the right atrial appendage and pericardial fluid; both cephalosporins, however, reach concentrations in these sites well above their minimal inhibitory concentrations (MICs) for penicillin-resistant staphylococci.

Evaluation of an oral prolonged-release antibiotic formulation.

The antibiotic cephalexin was formulated as an oral prolonged-release tablet and evaluated by in vitro dissolution testing as well as in vivo in 10 human subjects. Comparisons were made of the time course of the blood levels among the prolonged-release formulation, the commercially available capsule, and intravenous administration. Even though lower peak blood levels were attained in the prolonged-release tablet, absorption continued for at least 6 hr.

Cefazolin.

After 5 years of use, cefazolin can be considered similar to cephalothin as a therapeutic agent and in its potential for adverse reactions. When cefazolin and cephalothin are compared by appropriately designed clinical trials, neither cefazolin's slightly greater in-vitro susceptibility to staphylococcal beta-lactamase inactivation, nor its slightly greater microbiologic activity for some enterobacteraciae has been shown to result in any readily apparent therapeutic differences. The important differences between cefazolin and cephalothin--and this is also probably true with respect to cephapirin and cephradine--are not in therapeutic effectiveness, microbiologic activity, or toxicity but rather in pharmacokinetics and cost-effectiveness.

Pharmacokinetics of oral cephalosporins: cephradine cephalexin.

A crossover experiment was utilized to compare the pharmacokinetics of a 1-g dose of cephalexin tablets, cephalexin capsules, or cephradine capsules in nine normal human volunteers. These antibiotics were administered as three formulations: two 500-mg capsulin every 6 hr for five doses, and one 1000-mg tablet of cephalexin every 6 hr for five doses. Pharmacokinetic parameters in the experimental groups showed no statistical differences (p greater than 0.

Physiological perfusion model for cephalosporin antibiotics I: Model selection based on blood drug concentrations.

Various cephalosporins with different degrees of protein binding were administered to human volunteers. Blood samples were collected as a function of time and were assayed for drug content by a microbiological assay. A pharmacokinetic analysis of the data was performed using a two-compartment model with and without protein binding in the central compartment and a perfusion model.

The penetration characteristics of cefazolin, cephalothin, and cephradine into bone in patients undergoing total hip replacement.

Preoperatively, to prevent infection, seventy-one patients who were to have total hip arthroplasty were given one gram of cephalothin, cephradine, or cefazolin intravenously. Simultaneous samples of bone and serum were obtained after various time intervals and assayed for cephalosporin concentration to correlate the antibiotic concentrations in these sites with time. Of the cephalosporins tested, cefazolin achieved the highest total peak levels in bone (thirty micrograms per gram), followed in descending order by cephradine (twenty-three micrograms per gram) and cephalothin (2.

Comparison of concentrations of amoxicillin and ampicillin in serum and middle ear fluid of children with chronic otitis media.

Twenty-eight children aged five to nine years with chronic serous otitis media received a single dose of either ampicillin or amoxicillin by the oral route 1-2 hr before the removal of middle ear fluid by ventilation tubes inserted through the tympanic membrane. At the time middle ear fluid was obtained, a sample of blood was drawn from the patient, and levels of antibiotic in both specimens were microbiologically assayed by a disk diffusion method. Levels of amoxicillin (mean+/-standard error [SE], 1.

Stability of aspirin in propoxyphene compound dosage forms.

The stability of aspirin in propoxyphene compound capsules made by three manufacturers, stored under a variety of temperature and humidity conditions, was compared. The cotton packing was removed from 100-capsule bottles, and the containers were stored (capped) under the following conditions: 25 c37 C and 50 C at both high (90%) and low (10%) humidity. No desiccant was removed from the bottles if originally present.