Rapid Determination of Antimicrobial Susceptibility for Urgent Clinical Situations Get access A. L. Barry, Ph.D., MT(ASCP), A. L. Barry, Ph.D., MT(ASCP) Section of Infectious and Immunologic Diseases, Department of Internal Medicine, Scliool of Medicine, University of California at Davis, and Sacramento Medical Center, Sacramento, California Search for other works by this author on: Oxford Academic Google Scholar L. J. Joyce, B.S., MT(ASCP), L. J. Joyce, B.S., MT(ASCP) Section of Infectious and Immunologic Diseases, Department of Internal Medicine, Scliool of Medicine, University of California at Davis, and Sacramento Medical Center, Sacramento, California Search for other works by this author on: Oxford Academic Google Scholar A. P. Adams, B.S., A. P. Adams, B.S. Section of Infectious and Immunologic Diseases, Department of Internal Medicine, Scliool of Medicine, University of California at Davis, and Sacramento Medical Center, Sacramento, California Search for other works by this author on: Oxford Academic Google Scholar E. J. Benner, M.D. E. J. Benner, M.D. Section of Infectious and Immunologic Diseases, Department of Internal Medicine, Scliool of Medicine, University of California at Davis, and Sacramento Medical Center, Sacramento, California Search for other works by this author on: Oxford Academic Google Scholar American Journal of Clinical Pathology, Volume 59, Issue 5, 1 May 1973, Pages 693–699, https://doi.org/10.1093/ajcp/59.5.693 Published: 01 May 1973 Article history Received: 05 July 1972 Accepted: 13 September 1972 Published: 01 May 1973
Letters, Comments, and Corrections1 September 1972Gentamicin and Kanamycin NomogramsROGER W. JELLIFFE, M.D., DANIEL IVLER, PH.D.ROGER W. JELLIFFE, M.D.Search for more papers by this author, DANIEL IVLER, PH.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-77-3-480 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The article by Chan, Benner, and Hoeprich, describing their nomogram for gentamicin dosage in patients with renal insufficiency ( 1 ), was read with interest. Their nomogram is useful, and the data seem to be solid. Their discussion, however, might have been enhanced by a more complete reference to similar work done by others. For example, probably the first description of the relationship between the kinetic properties of drugs and proper dosage regimens was done by Augsberger for cardiac glycosides (2). This approach was refined and extended by the late Ekkehard Kruger-Thiemer into a formal theory of...References1. CHAN R, BENNER E, and HOEPRICH P: Gentamicin therapy in renal failure: a nomogram for dosage. Ann Intern Med 76:773-778, 1972 LinkGoogle Scholar2. AUGSBERGER A: Quantitatives zur Therapie mit Herzglycosiden. Klin Wochenschr 32:945, 1954 CrossrefMedlineGoogle Scholar3. KRUGER-THIEMER E: Formal theory of drug dosage regimens. J Theor Biol 13:212, 1966 CrossrefGoogle Scholar4. VAN ROSSUM J: Pharmacokinetics of accumulation. J Pharm Sci 57:2162-2164, 1968 CrossrefMedlineGoogle Scholar5. DEFARES J and SNEDDON I: The Mathematics of Medicine and Biology. Chicago, Year Book Medical Publisher, Inc., 1961, pp. 255-259 Google Scholar6. JELLIFFE R: An improved method of digoxin therapy. Ann Intern Med 69:703-717, 1968 LinkGoogle Scholar7. JELLIFFE R, BUELL J, and KALABA R: An improved method of digitoxin therapy. Ann Intern Med 72:453-464, 1970 LinkGoogle Scholar8. JELLIFFE R, BUELL J, and KALABA R: A computer program for digitalis dosage regimens. Mathematical Biosci 9:179-193, 1970 CrossrefGoogle Scholar9. MAWER G, KNOWLES B, and LUCAS S: Computer-assisted prescribing of kanamycin for patients with renal insufficiency. Lancet 1:12-15, 1972 CrossrefMedlineGoogle Scholar10. JELLIFFE R, BUELL J, and KALABA R: Computer-assisted kanamycin dose programs (abstract). Clin Res 18:137, 1970 Google Scholar11. JELLIFFE R, KNIGHT R, and BUELL J: Computer assistance for gentamicin therapy (abstract). Ibid., p. 441 Google Scholar12. JELLIFFE R: Nomograms for kanamycin and gentamicin therapy. Abstracts of the Eleventh Interscience Conference on Antimicrobial Agents and Chemotherapy, Atlantic City, N. J., 19-22 October 1971, p. 63 Google Scholar13. CHAN R, BENNER E, and HOEPRICH P: A nomogram to guide safe, effective gentamicin therapy in patients with renal failure. Ibid. Google Scholar14. IVLER D, STAMBOULIAN D, and JELLIFFE R: Studies with computer programs for kanamycin and gentamicin therapy. Ibid., p. 64 Google Scholar15. CUTLER R and ORME B: Correlation of serum creatinine concentration and kanamycin half-life. JAMA 209:539, 1969 CrossrefMedlineGoogle Scholar16. GINGELL J and WATERWORTH P: Dose of gentamicin in patients with normal renal function and renal impairment. Br Med J 2:19, 1968 CrossrefMedlineGoogle Scholar17. MCHENRY M, GAVAN T, and GIFFORD R: Gentamicin dosages for renal insufficiency. Adjustments based on endogenous creatinine clearance and serum creatinine concentration. Ann Intern Med 74:192-197, 1971 LinkGoogle Scholar18. GYSELYNCK A, FLEET W, and CUTLER R: Gentamicin pharmacokinetics: distribution volume, renal and plasma clearance in normal subjects of renal insufficiency (abstract). Clin Res 19:183, 1971 Google Scholar19. JADRNÝ L: Odhad glomerulárni filtrace z kreatininémie. Cas Lek Cesk 104:947-949, 1965 MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: ROGER W. JELLIFFE, M.D.; DANIEL IVLER, PH.D.Affiliations: Department of Medicine University of Southern California School of Medicine Los Angeles, Calif. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 September 1972Volume 77, Issue 3Page: 480-481KeywordsDrugsGlycosidesPharmacokinetics ePublished: 1 December 2008 Issue Published: 1 September 1972 PDF downloadLoading ...
The increasing need for rapid and accurate assay of antimicrobial agents in body fluids requires technical improvement of skills in these areas. A method for using a tabletop computer to simplify and shorten the statistical analysis of the laboratory data obtained by bioassay with the Olivetti Underwood Programma 101 has been developed so that a secretary or laboratory helper can rapidly develop the standard curves for each day's assays.
Gentamicin has been given to patients with compromised renal function or severe renal failure, in toxic or nearly toxic peak serum concentrations followed by long periods of subinhibitory serum levels. A nomogram to allow safe, inhibitory serum gentamicin levels (3 to 8 µg/ml) in a steady-state manner was developed. The nomogram regimen is based on an elimination constant (K2) for 8-hour periods, as developed from half-life values at various levels of Seventeen patients with renal failure and life-threatening infections caused by Gram-negative bacilli were treated according to the nomogram. All the infections were controlled, and serum gentamicin concentrations that were inhibitory yet nontoxic were documented in all patients, including two who had repeated hemodialysis.
Annals of the New York Academy of SciencesVolume 182, Issue 1 p. 106-117 MODE OF RESISTANCE AGAINST β-LACTAM ANTIBIOTICS IN STAPHYLOCOCCI F. H. Kayser M.D., F. H. Kayser M.D. Institute of Medical Microbiology University of Zurich Zurich, SwitzerlandSearch for more papers by this authorE. J. Benner M.D., E. J. Benner M.D. University of California School of Medicine Davis, Calif.Search for more papers by this authorR. Troy Ph.D., R. Troy Ph.D. University of California School of Medicine Davis, Calif.Search for more papers by this authorP. D. Hoeprich M.D., P. D. Hoeprich M.D. University of California School of Medicine Davis, Calif.Search for more papers by this author F. H. Kayser M.D., F. H. Kayser M.D. Institute of Medical Microbiology University of Zurich Zurich, SwitzerlandSearch for more papers by this authorE. J. Benner M.D., E. J. Benner M.D. University of California School of Medicine Davis, Calif.Search for more papers by this authorR. Troy Ph.D., R. Troy Ph.D. University of California School of Medicine Davis, Calif.Search for more papers by this authorP. D. Hoeprich M.D., P. D. Hoeprich M.D. University of California School of Medicine Davis, Calif.Search for more papers by this author First published: June 1971 https://doi.org/10.1111/j.1749-6632.1971.tb30649.xCitations: 19AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume182, Issue1The Problems of Drug-Resistant Pathogenic BacteriaJune 1971Pages 106-117 RelatedInformation
Journal Article Cephaloridine and the Kidneys Get access E. Jack Benner, M.D. E. Jack Benner, M.D. Department of Medicine School of Medicine University of California at DavisDavis, California Search for other works by this author on: Oxford Academic PubMed Google Scholar The Journal of Infectious Diseases, Volume 122, Issue 1-2, July-August 1970, Pages 104–105, https://doi.org/10.1093/infdis/122.1-2.104 Published: 01 July 1970
Journal Article A Simple, Rapid Test to Differentiate Penicillin-susceptible from Penicillin-resistant Staphylococcus aureus Get access A. P. Adams, A. P. Adams Search for other works by this author on: Oxford Academic PubMed Google Scholar A. L. Barry, A. L. Barry Search for other works by this author on: Oxford Academic PubMed Google Scholar E. Jack Benner E. Jack Benner Search for other works by this author on: Oxford Academic PubMed Google Scholar The Journal of Infectious Diseases, Volume 122, Issue 6, December 1970, Pages 544–546, https://doi.org/10.1093/infdis/122.6.544 Published: 01 December 1970 Article history Received: 30 June 1970 Revision received: 17 August 1970 Published: 01 December 1970
Staphylococcus aureus cells that are initially susceptible to cephalexin can be induced to acquire intrinsic resistance to cephalexin in comparatively few steps. Concomitantly, resistance to cephalothin, oxacillin, and dicloxacillin increases. By population analysis, there is heteroresistance to cephalexin in some strains of S. aureus. Heterogeneity in colonial morphology on prolonged incubation in the presence of subinhibitory concentrations of cephalexin may constitute an expression of such heteroresistance.
A disposable kit was tested as a means of detecting significant bacteriuria by quantitative culture of urine. The total error in 3,563 specimens tested by five investigators was less than 1%. The method was very effective in differentiating significant bacteriuria, i.e., more than 100,000 bacteria per ml of urine from uninfected urine. In specimens from patients with urinary tract abnormalities who had mixed bacterial flora, the absolute numbers obtained with the dip-inoculum method had a 10% variation when compared to results obtained by calibrated loop or dilution pour plate methods. Therefore, the main utility of the kit is for screening and following patients after therapy. A significant delay in time between inoculation of the medium in the kit with the freshly voided urine and incubation of the kit to promote growth did not affect the reliability of the kit as a method of doing quantitative urine cultures to detect bacteriuria.
The wire loop renal lesion of systemic lupus erythematosus (SLE) in one patient with the clinical features of postnecrotic cirrhosis and a "lupoid hepatitis syndrome" and in another patient with the clinical features of xanthomatous biliary cirrhosis were of interest because the deaths of both patients were caused by their renal lesion. Both patients had pathological features of chronic active hepatitis as well as renal lesions characteristic of SLE. A review of the pathology of SLE indicated that patients with SLE apparently do not die of liver disease and have only minimal changes in their liver caused by the SLE. On the other hand, numerous patients with chronic active hepatitis have developed a nonspecific nephritis. These two patients with long-standing, active hepatitis presented completely different clinical courses during their illnesses, but both died with chronic active hepatitis and lupus nephritis. This sequence of events proves that patients with active chronic hepatitis and nephritis can have a progression of their nephritis to such an extent that death due to renal failure ensues. The presence of active nephritis in a patient with chronic active hepatitis is further indication for immunosuppressive therapy and should provide a model for the further study of "autoimmunity."