Alterations in the Bacterial Flora of the Throat During Oral Therapy With Aureomycin

Meads, Manson

doi:10.1001/archinte.1951.03810040058003

Cited by 30 publications

(4 citation statements)

References 12 publications

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“…al., 1968;Johansen et. al., 1969), residence in the hospital environment (Johansen et al, 1972), and previous administration of antimicrobial agents (Lipman et al, 1946;Ory et al, 1946;Long, 1947;Meads et al, 1951;McCurdy and Neter, 1952;Elmes et al, 1953;Petersdorf et al, 1957;Louria and Kaminski, 1962;Tillotson and Finland, 1969;Price and Sleigh, 1970). It was hoped 'to define more clearly ithe clinical significance of various potential pathogens with a view to more rational therapy in individual patients.…”

Section: Discussionmentioning

confidence: 99%

Secondary Respiratory Infection in Hospital Patients: Effect of Antimicrobial Agents and Environment

Philp¹,

Spencer²

1974

BMJ

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359were "failures" and more rthan one-third actually regained all the weight lost. Moreover, though most of the "successes" or "modified successes" continued to maintain a steady weight the incidence of failure increased with the length of followup. This was especially true during the first 12 months, and follow-up reports for such short periods are of limited value.The results for the male and female patients appeared to be similar and suggest that those most overweight are least likely to succeed; however, the initial percentage excess weight was of no clear predictive value. We failed to substantiate the previous impression that the ability to reduce to within 25% in excess of the ideal weight is associated with increased prospects of long-,term sucoess. Long-term success, however, is closely correlated with regular attendance at the follow-up clinic, and only two patients were known to have kept their weight down despite a lengthy lapse of follow-up. Some of the patients who regained weight rapidly admitted that though superficially their eating habits had been reformed they continued to eat excessively but in secret.All the patien;ts were "failures" before admission and the primary reason for selection was their inability to respond satisfactorily ito conventional treatment despite regular supervision at an obesity clinic for at least a year. All were suffering either physically or psychologically from their morbid obesity. Thus for the small proporton of successes a mean weight loss of 27 kg at a mean follow-up of 27 months represents a worthwhile achievement. Success, however, cannot be gauged solely in terms of weight reduction. Ten patients had 12 elective operations, including hiatus hernia repair, cholecystectomy, and total hip replacement. Nine married, and among the women there were six pregnancies, including one full-term delivery in a previous habitual aborter. Eleven patients held jobs which pTeviously they could not have obtained. It follows that the distinction between success and failure is necessarily arbitrary, and many who regained weight did not regret the time spent in hospital.Therapeu-tic starvation could be better justified if patient selection were improved, but at present the long-term sequelae of the other form of radical therapy, bypass surgery, are uncertain. The current policy is to offer surgery only to selected patients who have regained weight after starvation.We wish to thank the many doctors, the nursing staff, and the other staff who were concerned in the care of these patients, and are grateful to Servier Laboratories for their very generous financial support. Rooth, G., and Carlstr6m, S. (1970

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Section: Discussionmentioning

confidence: 99%

Secondary Respiratory Infection in Hospital Patients: Effect of Antimicrobial Agents and Environment

Philp¹,

Spencer²

1974

BMJ

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“…It has long been recognized that the administration of antibiotics may suppress man's indigenous microflora (6)(7)(8)(9). Although this may result in superinfection (12,13), it is usually without obvious clinical consequence and is soon reversed after cessation of therapy.…”

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confidence: 99%

Bacterial interference: effects of oral antibiotics on the normal throat flora and its ability to interfere with group A streptococci

Sanders¹,

Sanders²,

Harrowe³

1976

Infect Immun

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The effects of orally administered penicillin and tetracycline on the composition of the normal throat flora and its interference with the growth of group A streptococci were evaluated by throat culture and an agar overlay technique. Tetracycline caused only a slight, transient quantitative decrease in the composition of the flora and interference activity. Penicillin caused significant quantitative and qualitative decreases in both the composition of the flora and interference activity. The diminution in interference activity persisted up to 3 weeks after therapy. The differences observed between the antibiotic regimens correlated with differences in initial susceptibility of the flora to the antibiotic used and emergence of the resistance during therapy. Results indicate that although effects of antibiotics on the composition of the flora are transient, effects on its ability to interfere with group A streptococci may persist long after therapy is discontinued. It is thus possible that penicillin therapy may enhance susceptibility of certain individuals to subsequent infection with group A streptococci.It has long been recognized that the administration of antibiotics may suppress man's indigenous microflora (6-9). Although this may result in superinfection (12, 13), it is usually without obvious clinical consequence and is soon reversed after cessation of therapy. In a previous prospective study, throat cultures were obtained from children and tested for the presence of organisms that were capable of inhibiting the growth of group A streptococci in vitro (3). During two sequential epidemics of asymptomatic group A streptococcal infections, it was observed that cultures from children who did not become infected more frequently contained inhibitory flora than cultures from children who became infected. Since the presence of inhibitory organisms was shown to be associated with resistance to infection, antibiotic suppression might be expected to diminish any protection afforded by the normal flora. The purpose of the present study was to evaluate the effects of orally administered antibiotics on the composition of the normal throat flora and its ability to inhibit the growth of group A streptococci. MATERIALS AND METHODS Throat cultures. Throat cultures were obtained with a dry, sterile cotton-tipped swab pressed firmly around Waldeyer's ring and in a crisscross pattern over the posterior pharyngeal wall. Swabs were immediately placed in 2 ml of brain heart infusion broth (Difco) and shaken vigorously for 3 min. Then 0.01 ml of the broth was placed on the surface of a 5% sheep blood agar plate and streaked for isolation of colonies in the four-quadrant fashion. Cultures were read after incubation for 24 h at 37 C in 10% CO2 in air. Therefore only aerobic and facultative constituents of the throat flora were considered in this study.Identification and quantitation of normal throat flora. Neisseria sp., Micrococcus sp., diphtheroids, and alpha-hemolytic and nonhemolytic streptococci were identified by colonial morph...

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“…This is not substantiated by experimental study. Reports of candidiasis complicating antibiotic therapy have included the use of chlortetracycline (Harris, 1950;Meads et al, 1951;McVay and Sprunt, 1951;Pappenfort and Schnall, 1951;Woods et al, 1951), penicillin (Barlas and Akyel, 1952;Oblath et al, 1951;Ormerod and Friedman, 1951), streptomycin (Ormerod and Friedman, 1951;Wolff, 1952), chloramphenicol (Gausewitz et al, 1951;Harris, 1950;Hewitt and Williams, 1950;Mangiaracine, 1951;Tomaszewski, 1951;, neomycin (Forbes, 1953;Livingood et al, 1952), oxytetracycline (Jackson et al, 1951;Sharp, 1954;Womack et al, 1952), and tetracycline (Wood et al, 1954). Of these antibiotics, chlortetracycline has been reported to stimulate the in vitro growth of C. albicans by Pappenfort and Schnall ( ), Moore (1951, and Huppert et al (1953).…”

Section: Discussionmentioning

confidence: 99%

PATHOGENESIS OF CANDIDA ALBICANS INFECTION FOLLOWING ANTIBIOTIC THERAPY III

1955

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Alterations in the Bacterial Flora of the Throat During Oral Therapy With Aureomycin

Cited by 30 publications

References 12 publications

Secondary Respiratory Infection in Hospital Patients: Effect of Antimicrobial Agents and Environment

Secondary Respiratory Infection in Hospital Patients: Effect of Antimicrobial Agents and Environment

Bacterial interference: effects of oral antibiotics on the normal throat flora and its ability to interfere with group A streptococci

PATHOGENESIS OF CANDIDA ALBICANS INFECTION FOLLOWING ANTIBIOTIC THERAPY III

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