[Ceftazidime in the therapy of gram-negative meningitis in childhood]. / Ceftazidim u terapiji gram-negativnih meningitisa u djecjoj dobi.

Six cases of neonatal meningitis due to E. coli (3 cases), K. pneumoniae (1 case), P. aeruginosa (1 case) and S. marcescens (1 case), and eleven cases of suckling and little child meningitis caused by M. influenzae (10 cases) and N. meningitidis (1 case) were treated with ceftazidime. The susceptibility of agents was qualitatively tested according to the disk-diffusion method, and quantitatively according to biological dilution method on liquid broth. Ceftazidime concentrations in cerebrospinal fluid and sera were determined by the modified microbiological method using diffusion on agar. Efficacy of ceftazidime therapy was assessed by quickness of cerebrospinal fluid "sterilization", duration of antimicrobial therapy and outcome of the disease. In spite of very good agents susceptibility to ceftazidime determined by disk-diffusion method, notable differences were found in quantitatively determined susceptibility (minimal inhibitory and minimal bactericidal concentration). Antibiotic penetrability was various in proportion with individual intensity of blood brain barrier break down. Bactericidal effect and prompt "sterilization" of cerebrospinal fluid within 48 hours after the beginning of ceftazidime therapy was achieved in those patients in whom ceftazidime cerebrospinal fluid concentration was 10 and several times higher than the minimal bactericidal concentration (all cases due to H. influenzae, N. meningitidis and E. coli). In these cases the issue of the disease was also favourable and none of the patients died.(ABSTRACT TRUNCATED AT 250 WORDS)

[Antimicrobial treatment of Haemophilus influenzae meningitis in childhood]. / Antimikrobno lijecenje Haemophilus influenzae meningitisa u djecjoj dobi.

Antimicrobial treatment of bacterial meningitis should be done by antibiotic to which the causative agent is susceptible, which attained serum levels ensure adequate penetration across the blood-brain barrier and which bactericidal levels in cerebrospinal fluid are achieved. A total number of 61 child in age from 2 months to 7 years with bacteriologically proved Haemophilus influenzae meningitis was included in the study. The possibility and usefulness of application of various antibiotics used in the treatment of this disease as well as the results attained have been discussed. A total number of 40 patients was treated with only one antibiotic (ampicillin 6, chloramphenicol 6, cefuroxime 3, cefotaxime 18, ceftazidime 7) and 21 patients were treated with combinations of antibiotics (ampicillin + chloramphenicol 14, cefuroxime + chloramphenicol 7). The causative agent was susceptible to the applied antibiotic in all cases. The agent susceptibility was estimated qualitatively by disk diffusion method and quantitatively by methods of minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC). Even 31.1% of H. influenzae strains were resistant to ampicillin. Penetration across the blood-brain barrier was monitored by estimation of antibiotic concentration in sera and liquor. Antibiotic concentrations in liquor attained the bactericidal levels. The same good results were attained with any of single applied antibiotics. In cases of delayed initiation of the antimicrobial therapy the appearance of neurological complications was more frequent, the outcome of the disease was worse and the duration of treatment was longer.(ABSTRACT TRUNCATED AT 250 WORDS)

Correlation between fluorimetric and microbiological methods for determination of cephalexin in urine and serum.

The fluorimetric and microbiological methods for the determination of serum and urine cephalexin were compared with the aid of coded samples in two different laboratories. The coefficient of correlation between the two methods for serum cephalexin was 0.94. At urine cephalexin concentrations above 0.5 g/l, the coefficient of correlations between two methods was 0.83. At lower concentrations (0.5 g/l), the coefficient of correlation was 0.72. It was concluded that the tested methods are comparable, equally sensitive and precise.

Antibacterial and antifungal activities of nitroxoline Mannich bases.

The in vitro activity of nitroxoline and its Mannich bases against bacteria and fungi was investigated. Nitroxoline and its derivative with diisopropylamine as an amino component, exhibited the highest antimicrobial activity. The optimum hydro/lipophilic properties (log P), both for antibacterial and antifungal activity, are about log P values of 2. The least effective compound was this nitroxoline Mannich base which has diethanolamine as an amino component.