Achievements and problems from the view of a physician. (50 years after Fleming)

L. D. Sabath

Research output: Contribution to journalArticle

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 languageUndefined/Unknown
Pages (from-to)251-256
Number of pages6
JournalPhilosophical Transactions of the Royal Society of London - Series B: Biological Sciences
Volume289
Issue number1036
StatePublished - 1980

Keywords

  • Anti-Bacterial Agents/ae [Adverse Effects]
  • Anti-Bacterial Agents/me [Metabolism]
  • Anti-Bacterial Agents/tu [Therapeutic Use]
  • Bacterial Infections/dt [Drug Therapy]
  • Cephalosporins/tu [Therapeutic Use]
  • Humans
  • Penicillin Resistance
  • Penicillins/tu [Therapeutic Use]

Cite this

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title = "Achievements and problems from the view of a physician. (50 years after Fleming)",
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.",
keywords = "Anti-Bacterial Agents/ae [Adverse Effects], Anti-Bacterial Agents/me [Metabolism], Anti-Bacterial Agents/tu [Therapeutic Use], Bacterial Infections/dt [Drug Therapy], Cephalosporins/tu [Therapeutic Use], Humans, Penicillin Resistance, Penicillins/tu [Therapeutic Use]",
author = "Sabath, {L. D.}",
year = "1980",
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journal = "Philosophical Transactions of the Royal Society B: Biological Sciences",
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TY - JOUR

T1 - Achievements and problems from the view of a physician. (50 years after Fleming)

AU - Sabath, L. D.

PY - 1980

Y1 - 1980

N2 - 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.

AB - 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.

KW - Anti-Bacterial Agents/ae [Adverse Effects]

KW - Anti-Bacterial Agents/me [Metabolism]

KW - Anti-Bacterial Agents/tu [Therapeutic Use]

KW - Bacterial Infections/dt [Drug Therapy]

KW - Cephalosporins/tu [Therapeutic Use]

KW - Humans

KW - Penicillin Resistance

KW - Penicillins/tu [Therapeutic Use]

M3 - Article

VL - 289

SP - 251

EP - 256

JO - Philosophical Transactions of the Royal Society B: Biological Sciences

JF - Philosophical Transactions of the Royal Society B: Biological Sciences

SN - 0800-4622

IS - 1036

ER -