Comparison of bactericidal activity of five antibiotics against Staphylococcus aureus

Article Abstract:

Staphylococcus aureus is a bacteria which is responsible for a number of different serious infections in humans. Among these is osteomyelitis, which can be either a focal infection of bone or an infection which spreads to include all tissues within the bone. It is becoming increasingly common to treat osteomyelitis on an outpatient basis with oral antibiotics. For this reason, a study was conducted to determine how effective each of five oral antibiotics might be against osteomyelitis; the bactericidal (bacteria-killing) activity of the blood was tested while the drugs were taken. The study was conducted on 10 healthy volunteers, none of whom had taken any antibiotics for at least a month. The patients took the oral antibiotics according to the schedule recommended for each drug. Blood was sampled about one-half hour before dose five to get a "trough" measurement, and the peak activity was determined by analyzing the blood sample taken one hour after dose 5. The bactericidal activity of the blood was determined by culturing the blood with two different strains of S. aureus, both of which had been isolated from infected patients. The results showed that cephalexin was the most effective, with clindamycin running a close second. Although clindamycin has been considered more bacteriostatic than bacteriocidal, the results of this study suggest that it is indeed bactericidal against Staphylococcus aureus. The study also found that the commonly prescribed mixture of trimethoprim and sulfamethoxazole was not effective. The results suggest that this treatment should not be used. Cephalexin is probably the best first choice in the management of osteomyelitis. However, the study found that ciprofloxacin is also effective; this drug may be the better choice when patient compliance is a concern, since it is taken only twice a day in contrast to the four doses per day required for many antibiotics. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Antibacterial agents, Staphylococcus aureus, Staphylococcal infections, Cephalosporins, Osteomyelitis, Cephalexin

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Efficacy of single-dose versus seven-day trimethoprim treatment of cystitis in women: a randomized double-blind study

Article Abstract:

Lower urinary tract infection and infection of the bladder, or cystitis, is especially common among sexually active young women. However, the best treatment protocol is still a matter of controversy. Some studies have suggested that a single dose of antibiotics is less effective than a three-day or seven-day regimen, while others have indicated that the extended treatment is of no additional benefit. A quick calculation reveals that many of these studies simply did not include a large enough number of patients to definitively answer these questions. To resolve the issue, 502 women with lower urinary tract infection were enrolled in a double-blind randomized study to compare a single dose of trimethoprim with a seven-day regimen of the same drug. A total of 425 cases could be evaluated for the effectiveness of treatment over the short term. Efficacy was 82 percent for the single-dose treatment and 94 percent for the seven-day treatment. Over a longer period of five to six weeks, the efficacy of the short-term treatment was found to be 71 percent, in contrast to 87 percent for the seven-day schedule. The 71 percent long-term efficacy suggests that about one in four patients treated in this manner will not be cured of the infection and will have to return for further treatment, which eradicates the supposed savings in time and expense which were the original arguments in favor of the single dose. It remains to be determined if a compromise, such as a three-day treatment, may retain the efficacy of the seven-day schedule while providing cost savings. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Infection, Urinary tract infections, Bladder, Cystitis

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