Experiences in the prophylaxis and treatment of clostridial infections in casualties from the invasion of Europe

Patterson, T. C.; Keating, C.; Clegg, Herbert W.

doi:10.1002/bjs.18003312911

Cited by 7 publications

(5 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The difference was apparent at all times from 8 to 72 h and was statistically significant at 10 to 24 h (P < 0.05). DISCUSSION C. perfringens type A has been the most common causative agent of human cases of gas gangrene in civilian as well as wartime settings (1,2,7,10,14,22). Studies with experimental animals indicate that penicillin is the drug of choice for the prophylaxis of gas gangrene caused by this bacterium (1-3, 8, 11, 21, 27 FIG.…”

Section: Resultsmentioning

confidence: 99%

“…Current therapy involves aggressive surgical debridement, administration of hyperbaric oxygen, and penicillin treatment (8,10,12,14,21,22). Because more than one species of clostridia may be cultured from the wound and since strains other than C. perfringens are more likely to be resistant to clindamycin, cefoxitin, chloramphenicol, and tetracycline (9,10,16,26), antibiotic resistance is an important consideration (10) in selecting an antimicrobial agent.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Comparison of single and combination antimicrobial agents for prevention of experimental gas gangrene caused by Clostridium perfringens

Stevens¹,

Laine²,

Mitten³

1987

Antimicrob Agents Chemother

View full text Add to dashboard Cite

The treatment of experimental gas gangrene caused by Clostridium perfringens was investigated by using combinations of antimicrobial agents. This study demonstrated that rifampin, penicillin, metronidazole, and clindamycin were all bactericidal against standard inocula (105 to 106 CFU). These antimicrobial agents were then administered to mice beginning 30 min after intramuscular injection of 109 CFU of C. perfringens type A.The highest doses used produced levels of drug in blood which exceeded the MIC by at least a factor of 40. In addition, other groups of mice received monotherapy at full dose or one-fourth full dose or combination antimicrobial therapy at full or one-fourth full dose. Among the single and combination antimicrobial treatments, metronidazole alone, clindamycin alone, and clindamycin plus penicillin were the most efficacious (P < 0.05). Although the survival of mice treated with clindamycin plus penicillin was greater than that of mice treated with clindamycin alone, the difference did not reach statistical significance (P > 0.05). In contrast, mice treated with a combination of metronidazole and penicillin demonstrated greater mortality than those treated with metronidazole alone (P < 0.05). In summary, combination antimicrobial therapy of experimental C. perfringens infection did not improve survival compared to that achieved with metronidazole or clindamycin alone, and some combinations significantly reduced survival (P < 0.05).

show abstract

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

Comparison of single and combination antimicrobial agents for prevention of experimental gas gangrene caused by Clostridium perfringens

Stevens¹,

Laine²,

Mitten³

1987

Antimicrob Agents Chemother

View full text Add to dashboard Cite

show abstract

“…This applies to both clostridial (Roding et al 1972;Demello et al, 1973) and non-clostridial infections (Schreiner et al, 1974). The introduction of penicillin in the latter part of the Second World War provided an excelleni opportunity to evaluate its role, but the evidence was inconclusive (Jeffrey and Thompson, 1944;Gledhill, 1945;Langley and Winklestein, 1945;Macfarlane, 1945;Paterson et al, 1945). This question, therefore, remains unanswered, and certainly Roding et a].…”

Section: Antibioticsmentioning

confidence: 99%

Gas gangrene and related infection: Classification, clinical features and aetiology, management and mortality. A report of 88 cases

Darke

King

Slack

1977

British Journal of Surgery

107

View full text Add to dashboard Cite

The clinical features of gas gangrene and related infection seen in 88 patients over a 10-year period are described. It is suggested that clostridial infection could be simply classified as either 'gas-forming' or 'non-gas-forming'. The gas-forming group represents the more severe form of infection. Non-clostridial gas gangrene may present in a variety of forms. The anaerobic streptococcus was the organism most frequently responsible, but these cases were indistinguishable from clostridial infection on clinical grounds. The treatment of gas gangrene in this series of patients is reported. Emphasis is laid on the importance of adequate prophylaxis with penicillin in patients at risk. The value of antibiotics in established infection remains equivocal. The evidence supporting the value of hyperbaric oxygen therapy is assessed and an attempt made to quantify the response to this treatment. Benefit was apparent in only a proportion of patients. A favourable response indicated clostridial infection and guaranteed immediate survival. Extensive debridement or amputation is unnecessary in this group. No response following hyperbaric oxygen therapy indicated widespread mixed clostridial and non-clostridial infection, or infection due to organisms other than clostridia. Urgent and extensive debridement and amputation remain the predominant measures in this group.

show abstract

“…However, it does seem to me possible that, just as in prophylaxis, so in therapy the value of penicillin has been rather overestimated, not so much by the surgeons with much experience of gas gangrene as by the profession in general. Penicillin is, at best, an adjunct to surgical treatment; it certainly cannot replace it (214,353,354,565,644,789,813). It must again be emphasized that these remarks are in no sense an attempt to decry penicillin, which certainly ought to be given locally and parenterally in every case of the disease.…”

Section: Traumatic Infectionsmentioning

confidence: 99%

The Histotoxic Clostridial Infections of Man 12

Maclennan

1962

Bacteriological Reviews

259

View full text Add to dashboard Cite

Experiences in the prophylaxis and treatment of clostridial infections in casualties from the invasion of Europe

Cited by 7 publications

References 3 publications

Comparison of single and combination antimicrobial agents for prevention of experimental gas gangrene caused by Clostridium perfringens

Comparison of single and combination antimicrobial agents for prevention of experimental gas gangrene caused by Clostridium perfringens

Gas gangrene and related infection: Classification, clinical features and aetiology, management and mortality. A report of 88 cases

The Histotoxic Clostridial Infections of Man 12

Contact Info

Product

Resources

About