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There is increasing concern regarding antimicrobial resistance in Pakistan. Data are limited on the prevalence, pattern of resistance and risk factors associated with resistant organisms. This Study was done to address these issues as they relate to common infection of male/female.
The most frequently prescribed drug products were reviewed for insights into prescribing and dispensing patterns for ambulatory patients. The indications for eight of the "top" drug products were considered to be pharmacologically or therapeutically questionable. The drug products were: tetracycline, systemic; Dimetapp; Empirin Compound with Codeine; Actified; Darvon Compound 65; Darvocet-N; Donnatal; and Keflex. Drug prescribing review and prescriber education are crucially needed, as well as formulary controls when feasible.
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A prospective, randomized, double-blind evaluation of Loridine-Keflex prophylaxis in a homogeneous group of 32 patients undergoing sequential cervical conization and vaginal hysterectomy is reported. There was no infectious or febrile morbidity in the 18 oatuebts receuvubg abtubuitucs, Morbidity occurred in six of 14 patients receiving placebos (P is less than 0.05). Antibiotic prophylaxis and conization-hysterectomy morbidity are discussed.
Different clinical materials collected from 100 patients admitted in hospital or who attended out door clinic were used. Antibiotics like Enoxabid, Fortum, Ceporex, Klaricid, Maxaquin, Zenacef, Ceporexin, Urixin, Septran, Keflex. Erythrocine, vibramycin and tetracycline were used for culture sensitivity.
Investigations were performed on the bactericidal activity of cephalexin (keflex) and normal cord serum (NCS) against Escherichia coli K1 strains isolated from UTI. A synergistic interaction of the antibiotic and NCS was found against the strains resistant and sensitive to the serum.
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We conducted a blinded taste test evaluating 12 antimicrobial suspensions by smell, texture, taste, aftertaste and overall acceptance. Drugs received cumulative scores in each category as well as a total score ranking. Overall Lorabid scored highest but not significantly higher than Keflex, Suprax and Ceclor, all of which score higher than the other test drugs. Cefzil and Augmentin scored just below this group of drugs and higher than all other test drugs. Vantin was inferior to these drugs primarily because of its low score in aftertaste. It was ranked along with V-Cillin-K, Veetids, Sulfatrim and Pediazole, the lowest scoring group of drugs other than Dynapen which scored lower than all other test drugs. No difference overall was detected between the two penicillin VK suspensions evaluated, V-Cillin-K and Veetids.
Although the number of severe infections occurring after vaginal hysterectomy are few,they sometimes result in the death of a patient or a protracted hospital course. A prospective double-blind study, using Keflex and Keflin in theraputic doses,was undertaken to elucidate more clearly the effect upon morbidity in vaginal hysterectomy. Cultures were taken form a catheterized urine specimen and the cervix of all patients before surgery. Cultures were repeated on the fourth postoperative day. Morbidity was defined as an oral temperature of 100.6 degrees F. on two separate occasions, 4hours apart in the postoperative period. Of the 60 patients studied thus far, 43.3 percent of the 30 placebo patients exceeded these febrile limits and were determined as thosewith infectious morbidity. Only 13.3 of the 30 patients who received the prophalatic drug showed this morbidity.
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Selected antibiotic advertisements in medical journals are discussed to illustrate the misleading information that is often disseminated to physicians by the pharmaceutical industry. Laboratory and clinical data are presented to question the validity of selected advertisements which (1) encourage the use of Keflex for severe respiratory infections in children, (2) recommend the use of Keflex for the treatment of bacterial bronchitis, (3) suggest that high tissue penetration is a unique property of Vibramycin, (4) present pooled susceptability data which do not reflect microbial resistance patterns in the patient's hospital, (5) recommend twice-daily administration of Ancef for urinary tract infections but do not clearly state the potential danger of this regimen for other infections, (6) suggest that gentamicin should be given to adults in only two dosage sizes for the treatment of serious Gram-negative infections, and (7) lead the reader to assume that only women need to be treated for Trichomonas infections. It is suggested that as antibiotics are marketed, hospital therapeutics committees should evaluate their advantages and permit formulary additions for only those agents demonstrating increased efficacy, decreased toxicity or decreased cost. Pharmacists who monitor drug therapy can provide information to the physician which will increase his awareness of optimal antibiotic therapy.
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Proteus species produces toxins and constitutes a causative agent of some chronic and recurrent infections. For the study of haemolytic activity and the production and inhibition kinetics, a total of 140 local isolates were diagnosed and examined by the general biochemical methods, and their ability of haemolysis were tested by both direct and indirect methods utilizing the enrichment procedure for all strains. Two antibiotics, erythromycin and keflex (cephalexin), were tested for the study of haemolysis inhibition and its kinetisc. Rof further study, examples of Proteus species were selected; the new approach was based on mixing procedure between P. aeruginosa (also pyocyanine) and Proteus species for inhibition of haemolytic activity. Spectrophotometric analysis were used parallel to these studies to support quantitatively the observed results as all samples show an absorption centre at 542 +/- 1 nm. Results of such analysis of haemolytic activity and inhibition kinetics are presented.
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The cases of two patients who took a cephalosporin antibiotic, cephalexin (Keflex, Eli Lilly), and then developed TTP are reported. One patient subsequently received a third-generation cephalosporin, ceftriaxone (Rocephin, Roche), without adverse reaction. Of interest, one patient had taken cefaclor (Ceclor, Eli Lilly) 8 years before and had also developed TTP at that time. The other patient also took cefaclor for approximately 3 weeks before taking cephalexin. In addition, she had had a dose of clarithromycin (Biaxin, Abbott Laboratories) the day before the onset of the TTP symptoms.
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Dysphagia and retrosternal pain are common complaints in patients after cardiac operations, and most often they result from the median sternotomy and/or endotracheal intubation. Although Candida esophagitis is a recognized cause of similar symptoms, it is usually not suspected except in immunologically compromised hosts. This report describes the case histories of five patients, not immunosuppressed or cachectic, who developed persistent dysphagia during recovery from cardiac operations; four patients received only 4 days of preoperative and postoperative prophylactic antibiotic treatment with cefazolin (Kefzol) and cephalexin (Keflex). A nasogastric tube had been used for less than 24 hours in the postoperative period. The fifth patient developed symptoms following prolonged and varied antibiotic therapy. Candida esophagitis was diagnosed by a combination of coexisting oral candidiasis (5/5), roentgenographic appearance on barium swallow (5/5), endoscopy (4/4), and biopsy or culture (2/4). Initial therapy consisted of antireflux measures and antacids (4/5), cimetidine (4/5), oral nystatin in methylcellulose base (1,000,000 units every 4 hours) (4/5), and termination of other antibiotic therapy (1/5). These measures were effective in clearing the infection in only two patients. A third patient required prolonged massive oral nystatin therapy, and in two patients intravenous Amphotericin B was necessary to control infection. Two patients subsequently developed strictures which necessitated multiple esophageal dilatations. One of these patients developed endocarditis during home dilatation therapy. All patients are currently free of disease. Current measures utilized to recognize and treat the disease are discussed.
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L-Keflex is a newly manufactured cephalexin product in order to maintain effective blood level of the drug for a long period of time. The results of the fundamental and clinical studies are as follows: 1. Mean blood levels of the drug after its single oral dose of 1 g in fasting in 22 cases before operations were: 7.19 mcg/ml at 2 hours (peak), 4.35 mcg/ml at 4 hours, 4.21 mcg/ml at 6 hours, 2.47 mcg/ml at 8 hours and 1.81 mcg/ml at 12 hours, respectively. Existence of the drug in blood was observed for a long period of time. 2. The distribution into the tissues of L-Keflex was generally good. The tissue levels in 19 of 22 samples ranged from 1.30 to 18.0 mcg/g, but 3 samples did not detect the drug in the tissues. Tissue level/blood level ratios were 0.19 approximately 2.67. 3. Half of 30 cases with mild dental infections was treated with a daily dose of 1 g with clinical response of 60.0%, and the other half with 2 g was 78.6% in clinical response. The overall efficacy rate was 69.0%. 4. As a side effect of the drug, only one of 52 cases (fundamental 22 cases, clinical 30 cases) complained of edema on both eyelids. No. abnormality was observed in blood finding, hepatic and/or renal function. From the above results, it is considered that L-Keflex is an effective antibiotic product in infections in the field of oral surgery. Also, L-Keflex has an advantage in that its administration frequence (b.i.d) is less than that of regular cephalexin (q.i.d.).