BACKGROUND: Hypersensitivity to penicillin has been studied worldwide, but data regarding patterns of sensitization in Arabian Gulf countries are scarce. OBJECTIVE: To describe the patterns of penicillin hypersensitivity during a 6-year study in Kuwait in terms of demographics, type of the culprit drug, in vivo and in vitro allergy testing. METHODS: One hundred and twenty-four patients referred to the drug allergy clinic for penicillin allergy were fully evaluated by skin prick and intradermal testing. Drug provocation test was done on patients with negative results. RESULTS: A total of 124 patients were evaluated for penicillin allergy. Mean age was 37.8 (standard deviation, 12.7) years, range from 8 to 74 years. Thirty-nine male (31.5%) and 85 female patients (68.5%) were included. Diagnosis of penicillin allergy was confirmed in 46 patients (37.1%). Among the 44 confirmed allergic patients by skin evaluation we had 15 (34.1%) positive skin prick test, and 29 (65.9%) positive intradermal testing. Among patients with positive skin testing, 47.7% were positive to major determinant benzylpenicilloyl poly-L-lysine, 20.4% to minor determinant mixture, 50.0% to penicillin G and 40.9% to ampicillin; 13.6% of patients were positive to amoxicillin by skin prick test. One patient had a positive radioallergosorbent test and one had a positive challenge test. CONCLUSION: Penicillin allergy is a common problem with an incidence of about one third in our study subjects.
Amoxicillin ; Ampicillin ; Demography ; Diagnosis ; Drug Hypersensitivity ; Female ; Humans ; Hypersensitivity ; In Vitro Techniques ; Incidence ; Intradermal Tests ; Kuwait ; Male ; Penicillin G ; Penicillins ; Radioallergosorbent Test ; Skin ; Skin Tests

In patients with urinary tract infections, institution of specific therapy should be preceded by careful examination of the urine and quantitative bacteriology from properly collected urine specimens. A clinical study on patients with urinary tract infections was done for observation of the changing trend in causative organisms and their susceptibility to antibiotics at Yonsei Medical Center in 1971 and 1976. The following results were obtained. 1) In 1971, 571 patients (male:2l1, female :360) with urinary tract infections were observed and in 1976, 647 patients (male :265, female :382) were observed. The ratio of male to female was 1 : 1.4-1.7, the most cases (above 60%) belonged to age group 20-49 years in both year. 2) The causative organisms of urinary tract infections were E. coli, enterobacter, staphylococcus and etc in 1971 and E. coli, enterobacter, klebsiella and etc in 1976 orderly. Cases of urinary tract infections by enterobacter and staphylococcus were decreased and cases by klebsiella, proteus and pseudomonas were increased in 1976. Urinary tract infections by E, coli were about 60% of female patients and about 25% of male patients in both year. Incidence of mixed urinary tract infections was l0.5% in l971 and 15.1% in 1976. 3) The susceptibility rates of gram negative organisms were 30.3% to ampicillin, 72.2% to Kanamycin, 79.9% to neomycin and 51,5% to bactrim in l971 and 17.5% to ampicillin, 47.8% to Kanamycin, 68.7% to gentamycin and 71.8% to colimycin in 1976. The rates to chloramphenicol, streptomycin and tetracycline were about 20% in both year. 4) The susceptibility rates of gram positive organisms were 35.4% to chloramphenicol, 38.5% to orbenin, 81.0% to penicillin G and 11.8% to tetraycline in 1971 and 50.0% to chloramphenicol, 31.6% to orbenin, 64.5% to penicillin G and 22.4% to tetracycline in 1976. The rate to ampicillin in 1971 was 57.0% and to cephaloridin in 1976 was 78.9%. 5) The susceptibility rates of Pseudomonas were 79.5% to colimycin and 59.1% to neomycin in 1971 and 88.7% to colimycin, 56.3% to gentamycin and 59.2% to carbenicillin in 1976. The rates to streptomycin, tetracycline, bactrim and minocycline were low.
Ampicillin ; Anti-Bacterial Agents ; Bacteriology ; Carbenicillin ; Cephaloridine ; Chloramphenicol ; Colistin ; Enterobacter ; Female ; Gentamicins ; Humans ; Incidence ; Kanamycin ; Klebsiella ; Male ; Minocycline ; Neomycin ; Penicillin G ; Proteus ; Pseudomonas ; Staphylococcus ; Streptomycin ; Tetracycline ; Trimethoprim, Sulfamethoxazole Drug Combination ; Urinary Tract Infections* ; Urinary Tract*

In patients with urinary tract infections, institution of specific therapy should be preceded by careful examination of the urine and quantitative bacteriology from properly collected urine specimens. A clinical study on patients with urinary tract infections was done for observation of the changing trend in causative organisms and their susceptibility to antibiotics at Yonsei Medical Center in 1971 and 1976. The following results were obtained. 1) In 1971, 571 patients (male:2l1, female :360) with urinary tract infections were observed and in 1976, 647 patients (male :265, female :382) were observed. The ratio of male to female was 1 : 1.4-1.7, the most cases (above 60%) belonged to age group 20-49 years in both year. 2) The causative organisms of urinary tract infections were E. coli, enterobacter, staphylococcus and etc in 1971 and E. coli, enterobacter, klebsiella and etc in 1976 orderly. Cases of urinary tract infections by enterobacter and staphylococcus were decreased and cases by klebsiella, proteus and pseudomonas were increased in 1976. Urinary tract infections by E, coli were about 60% of female patients and about 25% of male patients in both year. Incidence of mixed urinary tract infections was l0.5% in l971 and 15.1% in 1976. 3) The susceptibility rates of gram negative organisms were 30.3% to ampicillin, 72.2% to Kanamycin, 79.9% to neomycin and 51,5% to bactrim in l971 and 17.5% to ampicillin, 47.8% to Kanamycin, 68.7% to gentamycin and 71.8% to colimycin in 1976. The rates to chloramphenicol, streptomycin and tetracycline were about 20% in both year. 4) The susceptibility rates of gram positive organisms were 35.4% to chloramphenicol, 38.5% to orbenin, 81.0% to penicillin G and 11.8% to tetraycline in 1971 and 50.0% to chloramphenicol, 31.6% to orbenin, 64.5% to penicillin G and 22.4% to tetracycline in 1976. The rate to ampicillin in 1971 was 57.0% and to cephaloridin in 1976 was 78.9%. 5) The susceptibility rates of Pseudomonas were 79.5% to colimycin and 59.1% to neomycin in 1971 and 88.7% to colimycin, 56.3% to gentamycin and 59.2% to carbenicillin in 1976. The rates to streptomycin, tetracycline, bactrim and minocycline were low.
Ampicillin ; Anti-Bacterial Agents ; Bacteriology ; Carbenicillin ; Cephaloridine ; Chloramphenicol ; Colistin ; Enterobacter ; Female ; Gentamicins ; Humans ; Incidence ; Kanamycin ; Klebsiella ; Male ; Minocycline ; Neomycin ; Penicillin G ; Proteus ; Pseudomonas ; Staphylococcus ; Streptomycin ; Tetracycline ; Trimethoprim, Sulfamethoxazole Drug Combination ; Urinary Tract Infections* ; Urinary Tract*

A) Bacteriological study and sensitivity test against antimicrobial agents were made on 126 cases of infantile and childhood shigellosis treated at pediatric epartment of St. Vincent hospital from April, 78 to September, 80. The results are follows: 1. Sh. flexneri was most frequently isolated(86.5%) and the next was Sh. sonnei(13.5%). 2. The percentage of resistant strains against antimicrobial agents. Ampicillin: 95.2% Carbenicillin : 90.5% Cephalothin: 78.6% Choloramphenicol: 95.2% Gentamicin: 20.6% Kanamycin: 23.8% Lincomycin: 100% Methicillin: 100% B) The effect of rifampin on bacteriological cure and clinical course in group B shigellosis of sixty-four hospitalized children from one year to five years old age were compared with other antibiotics. gentamicin, ampicillin and trimethoprim-sulfamethoxazole. Based on our study, rifampin was most effective drug in curing of clinical symptoms of shigellosis and eradicating the organisms from stool, and gentamicin was similar effect. Trimethoprim-sulfamethoxazole twas less effective than rifampin and gentamicin, but more effective than ampicillin which has no appreciable effect on the course of shigellosis.
Ampicillin ; Anti-Bacterial Agents ; Anti-Infective Agents* ; Carbenicillin ; Cephalothin ; Child ; Child, Hospitalized ; Dysentery, Bacillary* ; Gentamicins ; Humans ; Kanamycin ; Lincomycin ; Methicillin ; Rifampin* ; Trimethoprim, Sulfamethoxazole Drug Combination

Antimicrobial susceptibility of the bacterial strains isolated from clinical specimens during the period from June, 1983 to June, 1986 in Yeungnam Medical Center was studied and the following results were obtained. 1. Staphylococcus aureus was highly susceptible to cephalothin and its susceptibility to methicillin was gradually reduced. 2. Streptococcus strains except enterococcus were generally susceptible to penicillin, while most enterococci were susceptible to only ampicillin. 3. Gram-negative rods including Escherichia coli were highly susceptible to amikacin and tobramycin. 4. Serratia were generally less susceptible to the amtimicrobials tested than other Enterobacteriaceae. Among them, Serratia marcescens showed the highest susceptibility to amikacin and chloramphenicol. 5. Pseudomonas aeruginosa revealed the highest susceptibility to amikacin and tobramycin and moderate susceptibility to carbenicillin and gentamycin. 6. Acinetobacter calcoaceticus revealed low susceptibility to most antimicrobials tested, showing only 30% susceptibility to amikacin, tobramycin and gentamycin in 1986.
Acinetobacter calcoaceticus ; Amikacin ; Ampicillin ; Bacteria* ; Carbenicillin ; Cephalothin ; Chloramphenicol ; Enterobacteriaceae ; Enterococcus ; Escherichia coli ; Gentamicins ; Methicillin ; Penicillins ; Pseudomonas aeruginosa ; Serratia ; Serratia marcescens ; Staphylococcus aureus ; Streptococcus ; Tobramycin

The purpose of this study was to obtain the basic information for the improvement of dental environment by investigating the presence of methicillin- or vancomycin-resistant Staphylococcus aureus (MRSA or VRSA) isolated from dental health care workers (DHCWs) and environment of the Chosun University Dental Hospital (CUDH) and a private dental clinic (control group). Staphylococcus aureus (S. aureus) was isolated from anterior nares of 42 DHCWs and 38 sites, unit chairs, x-ray devices, computers, etc., at 10 departments of the CUDH and 20 DHCWs and 11 sites at the private dental clinic. S. aureus was isolated on mannitol salt agar plate and confirmed by PCR with S. aureus species-specific primer. Antimicrobial susceptibility test of clinical isolates of S. aureus against several antibiotics including methicillin (oxacillin) was performed by investigating minimum inhibitory concentration (MIC) using broth microdilution assay. In addition, PCR was performed to detect the methicillin- or vancomycin-resistant gene. The data showed that one strain of S. aureus was isolated from DHCWs of the CUDH and three strains of S. aureus was isolated from 3 samples of the private dental clinic, respectively. All of the isolates from the CUDH and the private dental clinic had resistance to penicillin G, amoxicillin and vancomycin and susceptibility to oxacillin and ciprofloxacin. The S. aureus strains were already obtained the resistance to penicillin G and amoxicillin. These results suggest that two dental clinics were under relatively safe environment.
Agar ; Amoxicillin ; Anti-Bacterial Agents ; Ciprofloxacin ; Delivery of Health Care ; Dental Clinics ; Mannitol ; Methicillin* ; Methicillin-Resistant Staphylococcus aureus ; Microbial Sensitivity Tests ; Oxacillin ; Penicillin G ; Polymerase Chain Reaction ; Staphylococcus aureus* ; Staphylococcus* ; Vancomycin

Infection involving the spinal cord and cauda equina are much less common than intracranial infection. Among the above, bacterial infection in spinal epidural space are relatively uncommon but well recognized entity in adult and children. More than 300 cases with spinal epidural abscess are described in the literatures. Because of its rarity, there is delay in diagnosis and irreversible neurological sequelae in high percentage of cases. Infection of the spinal epidural space are accompanied by fever, tachycardia, headache, pain and tenderness in the back, weakness of the lower extremities and finally a complete paraplegia. The modes of infection are 1) direct extension from inflammatory process in adjacent tissues 2) perforating wounds or lumbar puncture 3) hematogenous route from the remote origin. The most frequent causative organism is staphylococcus aureus always, but pneumococcus, streptococcus, pseudomonas, typhoid bacillus, pyocyanus, oidium coccidioides and fungus are causative organisms occasionally. In spinal epidural abscess with complete paraplegia, the neurologic sequelae are permanent and unhappy. So the spinal epidural abscess is neurosurgical emergency in which early diagnosis and prompt surgery are necessary to avert permanent cord damage. Recently, the spinal epidural abscess has increasing tendency. We have treated 5 cases with spinal epidural abscesses from Nov. 1974 to Apr. 1976. The followings are results ; 1) Sex incidence showed male 2, female 3 and age incidence ranged from 21 years to 38 years, but 4th decade was most common. 2) Most common mode of infection was unknown though all cases have been applied the acupunture for the back pain several times. 3) Most avaliable procedures of diagnosis were the usual infectious symptoms, leukocytosis, increased erythrocyte sedimentation rate, obstructive responce by Queckenstedt test and findings of myelography, including increased protein and pleocytosis in cerebrospinal fluid. 4) All 5 cases had been performed total laminectomy from T3-L3, according to the lesions commonly in thoracic spine with spinal epidural abscess and had been treated with penicillin G, Methicillin and Geopen. 5) The prognosis was poor in 4 cases with complete paraplegia but 1 case with incomplete paralysis recovered completely.
Adult ; Bacillus ; Back Pain ; Bacterial Infections ; Blood Sedimentation ; Carbenicillin ; Cauda Equina ; Cerebrospinal Fluid ; Child ; Coccidioides ; Diagnosis ; Early Diagnosis ; Emergencies ; Epidural Abscess* ; Epidural Space ; Female ; Fever ; Fungi ; Headache ; Humans ; Incidence ; Laminectomy ; Leukocytosis ; Lower Extremity ; Male ; Methicillin ; Myelography ; Paralysis ; Paraplegia ; Penicillin G ; Prognosis ; Pseudomonas ; Spinal Cord ; Spinal Puncture ; Spine ; Staphylococcus aureus ; Streptococcus ; Streptococcus pneumoniae ; Tachycardia ; Typhoid Fever ; Wounds and Injuries

Effect of pivmecillinam hydrochloride was evaluated on 20 patients with cystitis and 13 patients with urethritis seen in urologic department of Kyungpook National University Hospital during past 4 months periods from April 1982 through August 1982. Pivmecillinam was given orally at a dose of 600mg (3 tablets) tid for 4 days (total 12 tablets) and following results were obtained. 1. In cystitis, effective result was observed in 19 out of 20 patients, giving therapeutic rate of 95%, and pivmecillinam was effective against all G (-) bacilli infections including E. coli except pseudomonas infection in 1. 2. In urethritis, effective result was noticed in 9 out of 13 patients, giving therapeutic rate of 70%, and pivmecillinam was effective against staphylococcus infection in 6 out of 7 patients, serratia infection in 1 out of 2 and G (-), bacilli infection in 1. However, it was ineffective against staphylococcus, serratia, enterococcus and unknown organism in 1 case, respectively. 3. As to the side effect, only diarrhea was observed in one of total 33 patients.
Amdinocillin Pivoxil* ; Anti-Bacterial Agents ; Cystitis ; Diarrhea ; Enterococcus ; Gyeongsangbuk-do ; Humans ; Pseudomonas Infections ; Serratia ; Serratia Infections ; Staphylococcus ; Urethritis ; Urinary Tract Infections* ; Urinary Tract*

Effect of pivmecillinam hydrochloride was evaluated on 20 patients with cystitis and 13 patients with urethritis seen in urologic department of Kyungpook National University Hospital during past 4 months periods from April 1982 through August 1982. Pivmecillinam was given orally at a dose of 600mg (3 tablets) tid for 4 days (total 12 tablets) and following results were obtained. 1. In cystitis, effective result was observed in 19 out of 20 patients, giving therapeutic rate of 95%, and pivmecillinam was effective against all G (-) bacilli infections including E. coli except pseudomonas infection in 1. 2. In urethritis, effective result was noticed in 9 out of 13 patients, giving therapeutic rate of 70%, and pivmecillinam was effective against staphylococcus infection in 6 out of 7 patients, serratia infection in 1 out of 2 and G (-), bacilli infection in 1. However, it was ineffective against staphylococcus, serratia, enterococcus and unknown organism in 1 case, respectively. 3. As to the side effect, only diarrhea was observed in one of total 33 patients.
Amdinocillin Pivoxil* ; Anti-Bacterial Agents ; Cystitis ; Diarrhea ; Enterococcus ; Gyeongsangbuk-do ; Humans ; Pseudomonas Infections ; Serratia ; Serratia Infections ; Staphylococcus ; Urethritis ; Urinary Tract Infections* ; Urinary Tract*

During The last 11 years from Jan. 1980 to Dec. 1990, 72 cases of salmonellosis has been admitted to the Department of Pediatrics of National Medical Center and evaluated clinical difference between typhoid fever and salmonella gastroenteritis. The results were as follows: 1) The annual incidence of salmonella gastroenteritis insalmonellosis was increased in the latter half of the eighties. 2) Both salmonellosis had its peak incidence in the summer. 3) Salmonella gastroenteritis was highest in the age of less than 5 year in contrast with the age of 6~9 year in typhoid fever. 4) The specimens isolated salmonellae were blood and stool in most cases, especially blood in typhoid fever and stool in gastroenteritis. 5) S.typhi was 16 cases, salmonella group A was 3 cases, group B was 16 cases and Group D and E were a case in each in isolated salmonellae. 6) On the antibiotic sensitivity test, S.typhi was sensitive to the most antibiotics. but the salmonella group B was relatively resisitant to Ampicillin, Carbenicillin, Tetracycline and Chloramphenicol.
Ampicillin ; Anti-Bacterial Agents ; Carbenicillin ; Chloramphenicol ; Gastroenteritis ; Incidence ; Pediatrics ; Salmonella ; Salmonella Infections* ; Tetracycline ; Typhoid Fever