After a single iv bolus injection of 2 g ceftazidime, concentrations were measured in serum and urine in volunteers and in serum, bone, bile and tissue fluid in patients. The serum half-life was 171 min in volunteers (n=6, average age 26 years) and 221 min in patients (n=12, average age 58 years). The peripheral volumes of distribution were also different, being 7.81 in volunteers and 11.31 in patients. Urinary recovery from the volunteers averaged 92% of the dose. Bone samples free from blood and taken from the femoral head, the pelvis or the femoral shaft contained an average of 24.1 mg ceftazidime per litre of organic bone at 30 min after injection and 19.7 mg/l at 2 h. Samples of fluid from the periprosthetic space after hip replacement contained 25.6 mg/l at 2 h and were above 8 mg/l at 10 h. Bile concentrations reached 36.4 mg/l at 90 min and were above 8 mg/l for over 8 h. Peritoneal fluid samples contained 27.6 mg/l at 1 h and 8.0 mg/l at 8 h. These concentrations are considered sufficient to treat most aerobic infections associated with surgery.
SUMMARYMethicillin-resistant Staphylococcus aureus isolates from an outbreak of 17 cases of wound infection in a municipal hospital were typed by conventional methods, phage typing by three sets of phages, reverse phage typing and plasmid profiles, as well as by genomic DNA fragment patterns obtained after Sma-I digestion and pulsed-field electrophoresis. These isolates were non-typable by phages, only some were typable by reverse phage typing and were not uniform in plasmid profile. Only the genomic DNA fragment patterns resulted in a clear discrimination of 2 strains (12 isolates for the first and 7 isolates for the second). Both strains were disseminated in different wards of the same hospital and one strain had obviously spread to another clinic in the same city.
Ceftazidime is a new parenterally applicable cephalosporin with high beta-lactamase stability and a remarkable activity against the Enterobacteriaceae and non-fermentative Gram-negative bacilli. The in-vitro activity of ceftazidime in general is comparable with that of cefotaxime and moxalactam. Ceftazidime proved the most active of the newer cephalosporins against Ps. aeruginosa, Ps. cepacia, Ser. marcescens and Pr. vulgaris. The bactericidal effectiveness of ceftazidime is excellent against the majority of species tested. Ceftazidime is a promising new beta-lactam antibiotic and the first clinical results seem to confirm the excellent in-vitro activity.
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