apalcillin and Pseudomonas-Infections

In an open, prospective clinical trial, we evaluated the safety and efficacy of apalcillin in the treatment of complicated urinary tract infection. 21 hospitalized adult patients received apalcillin 2 g IV Q8-12 h for 5-17 days. There were 8 upper tract and 13 lower tract infections. Of 25 functional or anatomic abnormalities of the GU tract among these patients, 9 (36%) were corrected during the study period. Effectiveness of apalcillin was determined by clinical and bacteriologic response. 16 (76.2%) patients had clinical cures, 4 (19.8%) had clinical improvement, and 1 (4.8%) had clinical failure. Based on 26 pretreatment isolates, there were 16 (61.5%) bacteriologic cures and 10 (38.5%) failures. Failures were due to 6 (23.1%) relapses, 2 (7.7%) superinfections, and 2 (7.7%) relapses with superinfection. Adverse reactions were mild, transient, and did not require discontinuation of treatment. Apalcillin appears to be a safe, although marginally effective single agent antibiotic for the treatment of complicated urinary tract infections.

Topics: Adult; Aged; Ampicillin; Clinical Trials as Topic; Escherichia coli Infections; Female; Humans; Middle Aged; Naphthyridines; Prospective Studies; Proteus Infections; Pseudomonas Infections; Recurrence; Urinary Tract Infections

The therapeutic activity of a combination of apalcillin and gentamicin was evaluated in experimental Pseudomonas aeruginosa infection in neutropenic mice. Mice made neutropenic by administration of cyclophosphamide were more susceptible to P. aeruginosa infection than normal mice. At both challenge levels of 2LD50 and 20LD50, therapy with gentamicin alone was more effective than that with apalcillin or piperacillin. However, therapy with apalcillin-gentamicin combinations was significantly more effective than that by either component alone, and was as active as that with piperacillin-gentamicin. These in-vivo findings correlated with those of in-vitro studies, thus establishing a synergistic effect when apalcillin and gentamicin were combined. The results show that apalcillin when combined with gentamicin is effective in treating serious P. aeruginosa bacteraemia in neutropenic mice.

Topics: Ampicillin; Animals; Drug Synergism; Drug Therapy, Combination; Female; Gentamicins; Mice; Microbial Sensitivity Tests; Naphthyridines; Neutropenia; Piperacillin; Pseudomonas Infections; Sepsis

The therapeutic efficacy of cefpiramide and apalcillin was evaluated and compared with that of six other antipseudomonal beta-lactam antibiotics in an experimental mouse burn infection due to Pseudomonas aeruginosa. Both cefpiramide and apalcillin were as potent as cefsulodin and more potent than carbenicillin, cefotaxime, cefoperazone, piperacillin and gentamicin in protecting the infected mice from fatal bacteraemia and in eradicating Ps. aeruginosa from the infected site.

Topics: Ampicillin; Animals; Anti-Bacterial Agents; Burns; Cephalosporins; Female; Mice; Naphthyridines; Pseudomonas Infections; Wound Infection

The in vitro and in vivo activities of PC 904 were tested against Pseudomonas aeruginosa isolated from infected eyes and were compared with carbenicillin and gentamicin. By the microtiter plate method, we tested 30 strains of P. aeruginosa in vitro; PC 904 was very active against 29, but one strain was resistant. In a comparative study, PC 904 was more active than carbenicillin but less active than gentamicin. In vivo tests were conducted on rabbit corneas infected with a strain of P aeruginosa isolated in El Salvador. At moderate and high dosage levels, PC 904'S efficacy was comparable to carbenicillin's but much less than gentamicin's. When tested for ocular toxicity, the subconjunctival administration of PC 904 was well tolerated. The drug's greater activity in vitro than in vivo was probably due to its high serum-binding capacity.

Topics: Ampicillin; Animals; Carbenicillin; Drug Synergism; Female; Gentamicins; In Vitro Techniques; Naphthyridines; Pseudomonas aeruginosa; Pseudomonas Infections; Rabbits