Search

Abstract:  A collection of 114 clinical Streptococcus milleri group (SMG) strains at the Ryukyu University Hospital obtained in 1999 and 2000, was identified and tested for susceptibility to 12 antibiotics. The percentage of strains with intermediate susceptibility to penicillin G was relatively high (14%). Cefaclor and cefotiam, with a MIC 90 of 2 μg/ml, were less active than cefotaxime. Strains nonsusceptible to erythromycin, clindamycin, and azithromycin were found with a frequency of 8%, 5%, and 4%, respectively. Almost all of the SMG strains were susceptible to fluoroquinolones (except for 1% of the strains nonsusceptible to levofloxacin), and sitafloxacin (DU-6859a) was the most active agent among the 12 tested antibiotics.

ABSTRACTThe activity of ABT-773 was studied against extracellular and intracellular Legionella pneumophilaand for the treatment of guinea pigs with L. pneumophilapneumonia. The ABT-773 MIC at which 50% of isolates are inhibited (MIC50) for 20 different Legionellasp. strains was 0.016 μg/ml, whereas the MIC50s of clarithromycin and erythromycin were 0.032 and 0.125 μg/ml, respectively. ABT-773 (1 μg/ml) was bactericidal for two L. pneumophilastrains grown in guinea pig alveolar macrophages. In contrast, erythromycin and clarithromycin had easily reversible static activity only. Therapy studies of ABT-773 and erythromycin were performed with guinea pigs with L. pneumophilapneumonia. When ABT-773 was given to infected guinea pigs by the intraperitoneal route (10 mg/kg of body weight), mean peak levels in plasma were 0.49 μg/ml at 0.5 h and 0.30 μg/ml at 1 h postinjection. The terminal half-life phase of elimination from plasma was 0.55 h, and the area under the concentration-time curve from 0 to 24 h (AUC0–24) was 0.65 μg · h/ml. For the same drug dose, mean levels in the lung were 15.9 and 13.2 μg/g at 0.5 and 1 h, respectively, with a half-life of 0.68 h and an AUC0–24of 37.0 μg · h/ml. Ten of 15 L. pneumophila-infected guinea pigs treated with ABT-773 (15 mg/kg/dose given intraperitoneally once daily) for 5 days survived for 9 days post-antimicrobial therapy, as did 14 of 15 guinea pigs treated with erythromycin (30 mg/kg given intraperitoneally twice daily) for 5 days. All of the ABT-773-treated animals that died appeared to do so because of drug-induced peritonitis rather than overwhelming pneumonia. None of 12 animals treated with saline survived. ABT-773 is as effective as erythromycin against L. pneumophilain infected macrophages and in a guinea pig model of Legionnaires' disease. These data support studies of the clinical effectiveness of ABT-773 for the treatment of Legionnaires' disease.

With the advent of HAART, dramatic progress has been made in the treatment of children with HIV infection. Rates of perinatal transmission have fallen significantly because of increased prenatal and newborn testing. New research has demonstrated the long-term positive effects of HAART on immune status, growth, and development. The metabolic effects of HAART are being evaluated. Improving medication adherence and managing psychosocial stressors continue to be challenges to treatment, particularly in adolescents. [ABSTRACT FROM AUTHOR]