The levels of doxycycline in serum, bile and the gallbladder wall were determined in 25 patients during cholecystectomy, by means of bioassay after previous intravenous administration of doxycycline. The mean biliary level exceeded 20 µg/ml, and the mean level in the gallbladder wall was greater than 2 µg/g. With few exceptions all the levels found clearly exceeded the MIC of most relevant pathogens. This was confirmed by the levels found in bile drained via T-Tube. Thus, clinically important breakdown of doxycycline by the mainly alkaline bile acids should not be anticipated.

Is the administration of doxycycline still indicated in bacterial infections of the gallbladder and the bile ducts

Die In-vitro-Aktivitat von Cefotaxim gegen 115 in den Jahren 1978 und 1979 aus pathologischem Material isolierte Stamme anaerober gramnegativer sporenloser Stabchen wurde in Bouillon- und Agar-Dilutions- sowie in Agar-Diffusionsversuchen gepruft. Auserdem wurden die Teststamme auf Cefotaxim-Abbau (Beta-Laktamase-Aktivitat) untersucht. Beta-Laktamase-Bildung wurde bei 78 saccharolytischenBacteroides-Kulturen sowie 50% derBacteroides oralis-Stamme festgestellt. Diese Kulturen zeigten in der Bouillondilutionsmethode meist hohere minimale Hemmkonzentrations-(MHK-)Werte als im Agar-Dilutionsversuch. Die Keime derMelaninogenicus- undFusobacterium-Sphaerophorus-Gruppe bauten Cefotaxim nicht ab und waren durch niedrige MHK-Werte charakterisiert. Die kumulativeBacteroidaceae-Wirkung von Cefotaxim betrug in der Bouillondilutionsmethode 37,3%, 52,4% und 76,2% bei Konzentrationen bis 8, 16 und 32 µg/ml. Die entsprechenden Hemmquoten in den Agar-Dilutionsversuchen lauteten 52,2%, 70,5% und 86,9%. Es bleibt zu klaren, welche MHK-Bestimmungsmethode das In-vitro-Aquivalent der therapeutischen Cefotaxim-Wirkung darstellt. Zwischen Hemmhofdurchmesser und MHK-Werten bestand keine Korrelation.

Cefotaxim-Empfindlichkeit von Bacteroidaceae

http://rd.springer.com/content/pdf/10.1007%2FBF01639411.pdf

Cefotaxim-Empfindliehkeit yon Baeteroidaeeae

The in vitro activity of doxycycline against 147 strains of gram-positive and gram-negative anaerobes was determined by broth dilution, agar dilution and agar diffusion tests. The strains were isolated from clinical specimens in 1977. Saccharolytic Bacteroides strains (39 B. fragilis, 6 B. thetaiotaomicron, 4 B. vulgatus) showed broth dilution MICs of less than or equal to 0.0625-4.0 microgram/ml after 5 h incubation and MICs of less than or equal to 16 microgram/ml after 15 h incubation at 37 degrees C. With strains of B. oralis, B. melaninogenicus ss. intermedius, B. corrodens, Veillonella sp. and Megasphaera elsdenii the broth dilution MICs were less than or equal to 0.0625-32 microgram/ml after 15 h incubation. Peptostreptococcus spp., Propionibacterium acnes, Eubacterium sp., Bifidobacterium sp. and Clostridium sp. had broth dilution MICs of less than or equal to 2 microgram/ml, whereas Peptococcus spp. were inhibited by less than or equal to 0.0625 to greater than 32 microgram/ml. With the great majority of strains tested, MICs were 2 to 256 times higher in agar than in broth dilution tests. Clinical and experimental studies seem to be needed to determine which of the in vitro data are correlated to the outcome of doxycycline therapy. Several groups and species were separately considered for statistical analysis of the relationship between zone size and MIC. With gram-positive anaerobes, correlation was poor between broth dilution MIC and zone size (correlation coefficients r = - 0.168 for Peptococcaceae, and r = - 0.108 for P. acnes). When calculating the regression lines for agar dilution MICs and zone diameters, a higher correlation was found (r = - 0.9 for Peptococcaceae; r = - 0.397 for P. acnes). With B. fragilis and other Bacteroides species correlation coefficients were r = - 0.807 to r = - 0.891 for broth and agar dilution MICs and zone size but stochastic linearity was lacking.

Comparison of three methods of susceptibility testing of bacteroidaceae, peptococcaceae and other anaerobes to doxycycline.

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Comparison of three methods of susceptibility testing of bacteroidaceae, peptococcaceae and other anaerobes to doxycycline.