Comparison of Ampicillin and Chloramphenicol in Treatment of Paratyphoid Fever

Sleet, R. A.; Sangster, G.; Murdoch, J. McC.

doi:10.1136/bmj.1.5376.148

Cited by 30 publications

(9 citation statements)

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“…Patel (1964) found that ampicillin was effective in treating early cases of acute typhoid fever, but was less effective in patients who had been ill for more than 7 days; chloramphenicol was usually effective at all stages of the disease. Sleet, Sangster & Murdoch (1964) found chloramphenicol to be more effective than ampicillin in shortening the acute stage of paratyphoid fever. Nevertheless, they suggested that ampicillin was probably more effective than chloramphenicol in the treatment of carriers.…”

Section: Discussionmentioning

confidence: 99%

Ampicillin Levels in Human Bile

Ayliffe

Davies

1965

British Journal of Pharmacology and Chemotherapy

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Section: Discussionmentioning

confidence: 99%

Ampicillin Levels in Human Bile

Ayliffe

Davies

1965

British Journal of Pharmacology and Chemotherapy

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“…15,1979 on April 28, 2019 by guest http://aac.asm.org/ Downloaded from tions. However, this double-blind study indicates that cyclacillin is better tolerated than ampicillin and results in a lesser incidence of diarrhea and rash.…”

Section: <0001)mentioning

confidence: 99%

“…Nearly all patients with infectious mononucleosis given 1.5 g or more of ampicillin will develop a rash (10), and an increased incidence of rash is known to occur with ampicillin therapy in patients with salmonella infections (15,16), cytomegalovirus infection (9), and chronic lymphatic leukemia (3).…”

Section: <0001)mentioning

confidence: 99%

Double-Blind Clinical Trials of Oral Cyclacillin and Ampicillin

Gold¹,

Hegarty²,

Deitch³

et al. 1979

Antimicrob Agents Chemother

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A double-blind study was performed to compare the clinical response and the incidence of side effects in 2,581 patients administered ampicillin or cyclacillin for infections of the genitourinary or respiratory tract, infections of the skin and soft tissues, or for otitis media. There was no significant difference in clinical response and bacterial eradication. All side effects, including diarrhea and skin rash, were approximately twice as frequent in patients treated with ampicillin.Cyclacillin, 6-(1-aminocyclohexanecarboxamido)penicillanic acid, belongs to a new group of semisynthetic penicillins designated as aminocyclic penicillins. It is acid stable, has a low serum binding capacity of less than 25%, distributes well into tissues, and is more resistant to staphylococcal penicillinase than ampicillin (12).The in vitro activity of cyclacillin against gram-positive and gram-negative microorganisms is 25 to 50% below that of ampicillin (17). However, tests of in vitro susceptibility have been shown to be poor indicators of the therapeutic activity of this drug. Cyclacilhin is as effective as ampicillin in mice infected with penicillin-susceptible Staphylcoccus aureus, Streptococcus pyogenes, S. pneumoniae, and Haemophilus influenzae, less effective against Proteus mirabilis, and slightly more effective against Escherichia coli (17).Peak serum concentrations of cyclacillin occur earlier and are three to four times greater in magnitude (6, 17) than equal doses of ampicillin.Clinical trials also have indicated that cyclacillin and ampicillin are equally safe and effective for a variety of infections caused by susceptible gram-positive and gram-negative microorganisms (8, 13). However, these studies have suggested that patients treated with cyclacillin develop fewer gastrointestinal disorders and cutaneous rashes than patients treated with ampicillin (5, 13). Consequently, a large doubleblind study was performed involving more than 2,500 patients to compare the efficacy and safety of both antibiotics.MATERUILS AND METHODS A total of 2,581 patients were treated with cyclacillin or ampicillin. A culture for the identification of the etiological agent was made from the source of infection before treatment was started. Quantitative clean midstream urine cultures were made from the urine of patients with urinary tract infections, and a count of at least 1 x 105 organisms per ml was considered indicative of infection.Cyclacillin and ampicillin were prepared as identical tablets or oral suspensions. Medications were allocated at random so that both physician and patient were unaware of which drug was given. No concomitant antibiotics or anti-infective agents were administered. Approximately 75% of the patients treated with cyclacillin and ampicillin were adults. Of the adult patients, 39% were males, 61% were females, and the mean age was 44.7 years. Children treated with the cyclacillin suspension had a mean age of 2.8 years, and children treated with the ampicillin suspension had a mean age of 3.6 years. Adults were trea...

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“…Almost 200 people were involved, 160 of whom were admitted to the Infectious Diseases Unit of the City Hospital, Edinburgh, and the outbreak provided the opportunity for assessing the efficacy of ampicillin in the treatment of salmonellosis and of comparing its effect with that of chloramphenicol (Sleet, Sangster and Murdoch, 1964). Patients were admitted to the trial only when the diagnosis was confirmed, either by isolation of the organism from stool or blood or by a positive Widal reaction together with good clinical evidence of paratyphoid fever.…”

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confidence: 99%