RESUMO
The activity of amoxycillin and ceftriaxone, alone and in combination, was tested against four strains of penicillin-resistant pneumococci in vitro and in an animal model. Three of the strains were also resistant to third-generation cephalosporins. Fractional inhibitory concentration indexes for combined amoxycillin and ceftriaxone were measured by the Etest method and were considered additive (1.2; 1.1; 1.3 and 1.3 for the four strains). Twenty-four hour time-kill curves for two strains showed that the combination was additive or synergic for concentrations up to the MIC of the single drugs. The efficacy of these antibiotics alone and in various combinations against strains 16089 and 11724 were investigated in vivo using prolonged (48 h) experimental fibrin clot infection in rabbits. The bacterial reductions (delta log10 cfu/g) obtained for all the antibiotic combinations tested were significantly higher than those of the single drug regimens. The in-vivo efficacy of amoxycillin was significantly correlated with the time for which its concentration was above the MIC and that of ceftriaxone was correlated with its maximal concentration. From these findings, we concluded that, at concentrations easily achievable in humans, the combination of amoxycillin and ceftriaxone was strongly synergic against infection due to penicillin- and cephalosporin-resistant pneumococci.
Assuntos
Amoxicilina/farmacologia , Ceftriaxona/farmacologia , Infecções Pneumocócicas/tratamento farmacológico , Streptococcus pneumoniae/efeitos dos fármacos , Amoxicilina/farmacocinética , Animais , Ceftriaxona/farmacocinética , Cefalosporinas/farmacocinética , Cefalosporinas/farmacologia , Relação Dose-Resposta a Droga , Resistência Microbiana a Medicamentos , Quimioterapia Combinada/farmacologia , Masculino , Testes de Sensibilidade Microbiana , Resistência às Penicilinas , Penicilinas/farmacocinética , Penicilinas/farmacologia , Coelhos , Fatores de TempoAssuntos
Neoplasias Orbitárias/congênito , Neoplasias Orbitárias/patologia , Teratoma/congênito , Teratoma/patologia , Proteínas do Citoesqueleto/metabolismo , Exoftalmia/diagnóstico por imagem , Feminino , Humanos , Técnicas Imunoenzimáticas , Recém-Nascido , Órbita/diagnóstico por imagem , Neoplasias Orbitárias/metabolismo , Teratoma/metabolismo , Tomografia Computadorizada por Raios X , alfa-Fetoproteínas/metabolismoRESUMO
We performed surgery according to the measurements found with the prism adaptation test (PAT) in 14 patients with acquired esodeviations. The amount of deviation, as determined with the prism cover test, ranged from 3 to 30 (mean 13.4) prism dioptres (PD) at distance. Prism-adapted deviations ranged from 31 to 57 (mean 41.2) PD. The average recession of the medial rectus was 4.8 mm, and the average resection of the lateral rectus was 6.7 mm. The mean esodeviation at distance after surgery was 6.8 PD. Our results suggest that the PAT may be useful and perhaps indispensable in the preoperative assessment of patients with certain types of acquired esodeviation.
