The inhibitory and bactericidal activity of N-formimidoyl-thienamycin in vitro against 131 clinical isolates selected for their gentamicin resistance was compared with that of cefotaxime and moxalactam. All strains were inhibited by N-formimidoyl-thienamycin concentrations within a range of 0.12-4 mg/l. N-formimidoyl-thienamycin was less active than cefotaxime and moxalactam against Escherichia coli and Klebsiella spp., and more active than all other antibiotics tested against Serratia spp., Enterobacter cloacae, Pseudomonas aeruginosa and Acinetobacter spp. In contrast to the other antibiotics N-formimidoyl-thienamycin showed a narrow margin of difference between minimal inhibitory and minimal bactericidal concentrations. N-formimidoyl-thienamycin is a promising antibiotic for the treatment of hospital infections with multi-resistant organisms.
Cefotetan was evaluated to determine the efficacy and safety of a 1 g dose administered intravenously twice daily in the treatment of complicated urinary tract infections (UTI). Sixty patients entered and 58 patients completed the study. Duration of treatment ranged from 7 to 16 days with a mean of 10.1 days. A satisfactory clinical response was observed in 85%. Eradication of the infecting organisms was prompt and complete in 45 patients. Relapse, reinfection or superinfection occurred in seven patients and in six patients the infecting organisms did not respond to treatment. Cefotetan was well tolerated but two patients had treatment withdrawn because of macular rash. It is concluded that cefotetan is highly effective in treating complicated UTIs.
The filamentous forms of a serum resistant Escherichia coli strain developed under in vitro exposure to subminimal inhibitory concentration of the compound LY 127935 showed a higher resistance against host defence than the nontreated control bacteria. Significantly diminished LD50 values and a longer lasting persistence in the peritoneal cavity of the mouse were found after intraperitoneal infection. In order to exclude the suggestion that the enhanced virulence was only due to the separation of filaments into normal virulent bacilli, the course of experimental infection with normal virulent germs was investigated under treatment with subtherapeutic doses of the antibiotic. When animals treated with repeated doses of 10–15 μg/kg of LY 127935 were intraperitoneally infected a significantly smaller elimination rate of bacteria was observed in the peritoneal cavity than in animals injected with saline.
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