Drugs online research references
Arch Otolaryngol Head Neck Surg. 1995 Dec;121(12):1405-9.
Role of bacterial interference and beta-lactamase-producing bacteria in the failure of penicillin to eradicate group A streptococcal pharyngotonsillitis.
Brook I, Gober AE.
Department of Pediatrics, Georgetown University, School of Medicine, Washington, DC, USA.
OBJECTIVE: To determine the association among bacterial interference and beta-lactamase production and penicillin failure in treating streptococcal pharyngotonsillitis. DESIGN: Fifty-two children who had acute pharyngotonsillitis caused by group A beta-hemolytic streptococci (GABHS) were treated for 10 days with penicillin. Surface tonsillar cultures were obtained before therapy and at 10, 21, and 42 days after termination of therapy. The cultures obtained before and 10 days after completion of treatment were processed for aerobic and anaerobic organisms; the other cultures were processed for GABHS only. RESULTS: Based on eradication of GABHS, 38 patients were in the classification bacteriologic "cure"; 14 were in the classification bacteriologic "failure" after therapy. In the cured group, before therapy alpha-hemolytic streptococci inhibiting their own GABHS were recovered in the cultures of 14 children (37%), and beta-lactamase-producing organisms (BLPB) were detected in the cultures of two children (5%). After therapy, inhibiting alpha-hemolytic streptococci were recovered in 31 cultures (82%), and BLPB were detected in five cultures (13%). In contrast, in the failure group, before therapy alpha-hemolytic streptococci were isolated in one culture (7%) and BLPB were recovered from nine cultures (64%). After therapy, alpha-hemolytic streptococci were recovered in four cultures (29%), and BLPB was recovered in 13 cultures (93%). CONCLUSIONS: These data show that the absence of interfering alpha-hemolytic streptococci and the presence of BLPB is associated with penicillin failure in the treatment of GABHS pharyngotonsillitis.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7488371&dopt=Abstract
J Bacteriol. 1995 Jul;177(13):3631-40.
Localization of penicillin-binding proteins to the splitting system of Staphylococcus aureus septa by using a mercury-penicillin V derivative.
Paul TR, Venter A, Blaszczak LC, Parr TR Jr, Labischinski H, Beveridge TJ.
Department of Microbiology, College of Biological Science, University of Guelph, Ontario, Canada.
Precise localization of penicillin-binding protein (PBP)-antibiotic complexes in a methicillin-sensitive Staphylococcus aureus strain (BB255), its isogenic heterogeneous methicillin-resistant transductant (BB270), and a homogeneous methicillin-resistant strain (Col) was investigated by high-resolution electron microscopy. A mercury-penicillin V (Hg-pen V) derivative was used as a heavy metal-labeled, electron-dense probe for accurately localizing PBPs in situ in single bacterial cells during growth. The most striking feature of thin sections was the presence of an abnormally large (17 to 24 nm in width) splitting system within the thick cross walls or septa of Hg-pen V-treated bacteria of all strains. Untreated control cells possessed a thin, condensed splitting system, 7 to 9 nm in width. A thick splitting system was also distinguishable in unstained thin sections, thereby confirming that the electron contrast of this structure was not attributed to binding of bulky heavy metal stains usually used for electron microscopy. Biochemical analyses demonstrated that Hg-pen V bound to isolated plasma membranes as well as sodium dodecyl sulfate-treated cell walls and that two or more PBPs in each strain bound to this antibiotic. In contrast, the splitting system in penicillin V-treated bacteria was rarely visible after 30 min in the presence of antibiotic. These findings suggest that while most PBPs were associated with the plasma membrane, a proportion of PBPs were located within the fabric of the cell wall, in particular, in the splitting system. Inhibition of one or more high-M(r) PBPs by beta-lactam antibiotics modified the splitting system and cross-wall structure, therefore supporting a role for these PBPs in the synthesis and architectural design of these structures in S. aureus.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7541399&dopt=Abstract
Isr J Med Sci. 1995 Jul;31(7):432-5.
Can an educational program improve the diagnosis and treatment of pharyngotonsillitis in the ambulatory care setting?
Raz R, Porat V, Ephros M.
Infectious Diseases Unit, Central Emek Hospital, Afula, Israel.
The influence of an educational program on the diagnosis and treatment of pharyngotonsillitis was evaluated in three outpatient clinics in northern Israel during two periods. During both periods--1 January to 31 March 1988 (baseline phase) and 1 January to 31 March 1989 (study phase)--clinical data of all patients for whom antibiotics were prescribed were recorded on special forms, which included the patient's diagnosis and the antibiotic prescribed. In November 1988, 2 months before the study phase, two 1 h sessions on pharyngitis were given by the study physicians to the entire medical staff of two clinics (Clinics B and C), and written material was distributed. A third clinic (Clinic A) served as the control. A comparison of the prescribing habits during the two phases showed that during the study phase the total number of antibiotics prescriptions for pharyngitis declined significantly in Clinics B and C, while the percentage of prescriptions for penicillin V rose with the concomitant decline of amoxycillin. There were no significant changes in prescribing habits in the control clinic. These results show that a modest 2 h educational program involving direct contact with the entire medical staff of the community outpatient clinics can improve the diagnosis of pharyngotonsillitis and reduce both the inappropriate use of antibiotics in general, and the substitution of more expensive antibiotics for cheaper, equally effective ones.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7607871&dopt=Abstract
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