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[Treatment of pseudomonas infection with the new ureidopenicillin, azlocillin (author's transl)]
Abstract:
Azlocillin, in vitro four to eight times more effective against Pseudomonas aeruginosa than carbenicillin, was administered to 30 patients severely ill and having an additional pseudomonas infection. The drug was given at a dose of 4-6 g, in one case 8 g, per day, sometimes together with an aminoglycoside. Treatment was effective in 20, improvement occurred in five and failure only in four. In one instance the effect of the drug could not be evaluated. Results were particularly striking in septicaemia and necrotising external otitis. Pulmonary and wound infections in patients with circulatory disturbances did not respond so well. There were no serious side effects. The drug should not as yet be used at too high a dosage.
Insights
Azlocillin demonstrates significant efficacy against Pseudomonas aeruginosa infections in severely ill patients. While effective in most cases, optimal dosing requires further investigation to avoid potential issues.
Area of Science:
- Pharmacology
- Microbiology
- Clinical Medicine
Context:
- Pseudomonas aeruginosa infections pose a significant threat, especially in critically ill patients.
- Carbenicillin, a previous standard, shows lower in vitro efficacy compared to azlocillin.
- Limited treatment options exist for severe Pseudomonas aeruginosa infections.
Purpose:
- To evaluate the clinical efficacy and safety of azlocillin in patients with severe Pseudomonas aeruginosa infections.
- To compare the in vitro effectiveness of azlocillin and carbenicillin against Pseudomonas aeruginosa.
- To identify patient subgroups that respond best or poorly to azlocillin treatment.
Summary:
- Azlocillin, exhibiting 4-8 times greater in vitro activity against Pseudomonas aeruginosa than carbenicillin, was administered to 30 severely ill patients with Pseudomonas infections.
- Treatment with azlocillin (4-6 g/day, sometimes with aminoglycosides) resulted in effectiveness in 20 patients, improvement in five, and failure in four.
- Striking results were observed in septicaemia and necrotising external otitis; pulmonary and wound infections in patients with circulatory disturbances responded less favorably.
Impact:
- Azlocillin shows promise as an effective treatment for severe Pseudomonas aeruginosa infections, particularly in cases of septicaemia and necrotising external otitis.
- The study highlights the need for careful dosage considerations, as high doses may not be optimal.
- Further research is warranted to establish optimal dosing regimens and identify all patient populations that can benefit from azlocillin therapy.