Previous Antibiotic Treatment Research Articles

Pyogenic Osteomyelitis of the Spine???A Review of 16 Consecutive Cases

Pyogenic osteomyelitis of the spine is an uncommon disease. A series of 16 cases is reported. The site of involvement includes the lumbar, cervical, and thoracic segments, in that order of frequency of occurrence. Drug addiction and diabetes mellitus are important predisposing factors. The spectrum of clinical presentation is described. Late presentation is usually masked by old age, debilitation, and previous antibiotic treatment. Rapid progression with septicemia is also encountered. The importance of differentiating this condition from tuberculosis spondylitis is emphasized. Definitive diagnosis should depend on bacteriological, histological, and, with the recent introduction of antituberculosis antibody test, serological studies. Timely surgical intervention is indicated in complicated cases. Radical excision and anterior spinal fusion yields early and complete eradication of the infected material plus arthrodesis, which prevents late collapse of the spine.

La glomerulonefritis aguda en el niño: Estudio prospectivo de aspectos clinicos, histopatologicos e inmunologicos

Forty live ehildren (23 boys) 22to 15 years old (mean age 7.7 years) with clinical and histological evidence ofacute glomerular nephritis (AGN) were followed by 30 months. A.II patients were studied with percutaneous renalbiopsies in tlic first month after the begining of the disease (mean 20 days) and in 31 patients, a second renal biopsywas done: in 12 at x 194 days (range 171 to" 212 days) and in 19 at x 590 days (range 418 to 999 days). With only 5exceptions (11.1%) all patients recalled clinical evidence of antecedent cutaneous (37.8%), respiratory (51.1%) orcombined cutaneous and respiratory infections (11.1%) but group A bctha hcmolitycus estrep toco ecus (GABHE)was only isolated from six patients, probably because of previous antibiotic treatment. Edema and hypertensiondissapearcd in a mean of 8.8 and 4.3 days respectively. Haematuria was present in only 44%of the patients in thefirst urine examination, protemuria in 51% and eilindruria in 29.9% of the cases, but at last, hematuria wasdemonstrated in 41 /45 patients; proteinuria, that was present in a!3 cases without hematuria, finally ocurred in 95%of all the affected children and eilindruria was detected in 64%of the total series. A good correlation was found inthe histologic study between the magnitude of the lesions at optic and electronic microscopy. In the first biopsy allpatients showed segmental intramembranous, inrnune deposits. In the second series of renal biopsies the intensity ofthe lesions was, clearly, lesser at six months and the microscopical findings were already normal in three cases at 590days.(Key words: Acute glomerular nephritis, symptoms, evolution, renal biopsy, histologic findings, follow up,prognosis).

Intrauterine inoculation of a bacteria-free filtrate of streptococcus zooepidemicus in clinically normal and infected mares

The effects of the intrauterine inoculation of a bacteria-free filtrate of Streptcoccus zooepidemicus (Strep, filtrate) were studied in a group of mares with clinically normal and chronically inflamed uteri. The reaction was monitored at predetermined intervals by clinical, histological and bacteriological examination. The response was dramatic, although transient, and characterized by an acute suppurative endometritis in all test mares. The control group, infused with Brain-Heart Infusion Broth (BHIB) exhibited a less severe reaction which consisted primarily of an acute eosinophilic endometritis. The Strep filtrate inoculation did not interfere with the subsequent ability of the mares to conceive and carry a foal to term, and has proven to be a useful therapy in cases where previous antibiotic treatments have failed to rid the mare of a chronic infection.

Problems in atypical purulent pyelonephritis.

This study stresses the dangers of uncritical antibiotic treatment of acute purulent pyelonephritis. It may make the clinical picture atypical, prevent early diagnosis and timely operation, give rise to septicaemia and shock, as confirmed in the literature and by own observations. The incidence of complications (septicaemia, uraemia, septicaemic shock) and the mortality rate (31%) were strikingly high in the 77 cases of acute purulent nephritis with previous antibiotic treatment in the past 3 years. Early diagnosis and timely surgical intervention improve the therapeutic results.

Resistant urinary infections resulting from changes in resistance pattern of faecal flora induced by sulphonamide and hospital environment.

The faecal flora was studied in eight children admitted to hospital for treatment of a first urinary infection with sulphonamides. The original, sulphonamide-sensitive Escherichia coli organisms were found to disappear, to be replaced by other E. coli serotypes that were almost invariably resistant to sulphonamides. Some of these serotypes carried R-factors for multiple antibiotic resistance.Possibly some urinary infections with antibiotic-resistant organisms may be due to faecal organisms whose resistance has been changed by previous antibiotic treatment. Hence it is important to study the effects of individual antibiotics on the faecal flora.

Cephaloridine compared with penicillin and streptomycin in chronic purulent bronchitis: Controlled trials of increasing dosage of cephaloridine

Cephaloridine in ascending doses and penicillin administered with streptomycin were compared in successive trials. The patients had chronic purulent bronchitis or bronchiectasis, resistant to all previous antibiotic treatment. In a dosage of 2 G. daily, cephaloridine was inferior to penicillin with streptomycin, in one of 4 G. it was equal and in one of 6 G. superior in effect. Transient renal changes caution the use of this last dose.