azlocillin and Otitis-Media

Azlocillin, an acylureidopenicillin particularly active against Pseudomonas aeruginosa, was used to treat 124 patients, 36 of whom were children, presenting with pulmonary infections (including cystic fibrosis), urinary, genital, intra-abdominal, osteoarticular and skin infections as well as septicaemia, otitis and meningitis. The causative agent in all cases was Ps. aeruginosa either alone or associated with other pathogens. Azlocillin was administered alone in 75% of the cases and in combination with an aminoglycoside in 25%. Dosage was 240 mg/kg/24 h in three intravenous infusions in adults and in children older than 3 months, and 75 to 225 mg/kg/24 h in two intravenous injections in neonates and prematures. The duration of treatment varied according to the site of infection, with a mean of 10 days. One-hundred and eight pathogenic organisms were isolated, including 114 strains of Pseudomonas, 43 of which were carbenicillin-resistant. A satisfactory clinical response was observed in 86.5% of the infections. The bacteriological response was similar to the clinical response, with 76.6% cures, 10% improvements and 13.5% failures. Microbiologically, 77.5% of the germs were eradicated, 7.5% reappeared and 15% persisted. Azlocillin was well tolerated systemically and biochemically and had no detrimental effect on renal function.

Topics: Adult; Azlocillin; Bacterial Infections; Child; Clinical Trials as Topic; Humans; Meningitis; Middle Aged; Otitis Media; Penicillins; Pseudomonas aeruginosa; Pseudomonas Infections; Respiratory Tract Infections; Sepsis; Urinary Tract Infections

Azlocillin has a broad spectrum particularly against pseudomonas and should therefore be useful for preoperative parenteral treatment of infected cholesteatomas in those cases which cannot be controlled by local therapy. To determine the efficacy in treatment of cholesteatoma the concentration of azlocillin in separate tissue fractions of cholesteatoma matrix, cholesteatoma debris and granulation tissue surrounding cholesteatoma was determined. In 9 cases 2 g azlocillin was injected and in 5 cases 4 g. The concentration drop between the different tissue fractions was equal in all cases. However, as clinical experience has shown, differing high levels of azlocillin were found in comparable tissue fractions of the 14 cholesteatomas. In some of the cases the minimal antibacterial activity was not attained in the cholesteatoma fractions.

Topics: Azlocillin; Bacterial Infections; Cholesteatoma; Humans; Infusions, Intravenous; Microbial Sensitivity Tests; Otitis Media; Premedication

Topics: Animals; Azlocillin; Guinea Pigs; Kinetics; Labyrinthine Fluids; Otitis Media; Penicillins; Perilymph; Staphylococcal Infections

The results of studies on the pharmacokinetics of azlocillin in the perilymph of the guinea pig following the intramuscular administration of 200 mg per kg body weight are shown graphically. Similar to mezlocillin and the aminoglycoside antibiotics, this new acylureido penicillin is retained in the inner ear. The results of our studies, together with the data on the in vitro and in vivo activity of azlocillin and gentamicin and the applicable dosage for clinical purposes, indicate that the azlocillin levels in the perilymph are considerably more effective against Pseudomonas aeruginosa and many times more effective against the other microorganisms usually involved in acute otitis media than those of the aminoglycosides.

Topics: Animals; Azlocillin; Guinea Pigs; Kinetics; Labyrinthine Fluids; Otitis Media; Penicillins; Perilymph