Achievements and problems from the view of a physician.

L D Sabath

Research output: Contribution to journalArticle

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Abstract

Penicillin made possible the cure of many common, and also the most serious, infections, such as meningococcal meningitis and bacterial endocarditis, often with few or no sequelae. Endocarditis had been invariably fatal. Semisynthetic penicillins added new dimensions of convenience of administration and a broader spectrum in the presence of many beta-lactamases. A quantum step forward was permitted by the derivatives of cephalosporin C. Specific clinical advances were (1) the opportunity to use these in some penicillin-allergic patients, (2) activity against wider range of Gram-negative bacilli, (3) activity against Bacteroides fragilis (cefoxitin), (4) more complete renal excretion after oral cephalosporins than with oral penicillins, and (5) delayed renal excretion. Major remaining problems limiting beta-lactam use are (1) allergy, (2) resistant organisms, (3) relatively poor entry into the cerebrospinal fluid (especially of cephalosporins, (4) some nephrotoxicity, (5) local irritation of veins and tissues during administration, and (6) poor results in patients with agranulocytosis.

Original languageEnglish (US)
Pages (from-to)251-256
Number of pages6
JournalPhilosophical transactions of the Royal Society of London. Series B, Biological sciences
Volume289
Issue number1036
DOIs
StatePublished - Jan 1 1980

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penicillins
physicians
Penicillins
cephalosporins
Physicians
endocarditis
Cephalosporins
mouth
excretion
Bacteroides fragilis
kidneys
Meningococcal Meningitis
Allergies
Cerebrospinal fluid
Bacterial Endocarditis
Cefoxitin
beta-lactams
nephrotoxicity
Agranulocytosis
beta-lactamase

Cite this

Achievements and problems from the view of a physician. / Sabath, L D.

In: Philosophical transactions of the Royal Society of London. Series B, Biological sciences, Vol. 289, No. 1036, 01.01.1980, p. 251-256.

Research output: Contribution to journalArticle

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