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A Jedlicková

Publications and source records attributed to A Jedlicková.

14 recordsLinked to original sources
PubMed2006

[Cefepime as an empiric treatment of febrile neutropenia in patients after high dose therapy and autologous stem cell transplantation].

BACKGROUND: Febrile neutropenia is one of the most frequent complications in intensively treated hematooncological patients and almost inevitably occurs after high dose therapy and autologous stem cell transplantation. Empiric broad-spectrum antibiotic treatment is indicated in the initial management. Fourth-generation cephalosporins are the option. This retrospective study was initiated to assess efficacy and safety of cefepime as an empiric therapy of febrile neutropenia following high dose therapy and autologous stem cell transplantation. METHODS AND RESULTS: 319 high dose therapy procedures with autologous stem cell transplantation in 287 patients mostly with hematological malignancies were performed at our department between January 2002 and December 2005. We present analysis of 169 out of 229 febrile episodes in 163 patients (median age 53) being treated with cefepime in the initial empiric treatment of febrile neutropenia. 12 episodes (7.1 %) were clinically documented (pneumonia 9, sinusitis 2, acute cholecystitis 1), 60 (35.5 %) were confirmed microbiologically (presented as bacteremia) and 97 (57.4 %) were fever of unknown origin. 50 isolates (83.4 %) out of 60 microbiologically documented infections were G-positive bacteria, 8 isolates (13.3 %) were G-negative bacteria and 2 (3.3 %) were mixed G-positive and G-negative cultures. According to the MASCC score 14 episodes were assessed as high risk. Effect of cefepime as a single agent was observed in 85 episodes (50.3 %) and in 22 (13.0 %) episodes treated with combination therapy due to susceptibility of isolated pathogen in blood culture. Combination therapy of two antibiotics (cefepime + aminoglycoside or glycopeptide) given for persistent fever was effective in 13 patients (7.7 %). Treatment failure was observed in 48 (28.4 %) episodes, we registered 10 death. CONCLUSIONS: Therapy with cefepime represents an appropriate choice for empiric antibiotic treatment of febrile neutropenia in hematooncological patients. Cefepime demonstrates clinical safety and efficacy and can be used in monotherapy or in combination with other drugs (overall response 72.2 %, as a single agent 50.3 %).

Adult↗
PubMed2006

[Occurrence of the yeast and filamentous fungi in haematological patients during 2002 to August 2005].

BACKGROUND: The number of diseases caused by yeast and fungi has been increasing recently. The primary disease is caused by dermatophytes and Cryptococcus neoformans. Other types of yeast and fungi can cause secondary infections of patients with predisposition factors. Among the mycotic diseases diagnosed in our laboratory can be included candidosis, cryptococcosis, aspergillosis and mucormycosis. METHODS AND RESULTS: In haematological patients Candida albicans, Candida glabrata, Candida krusei, Candida tropicalis and Saccharomyces cerevisiae are the most frequently diagnosed. CONCLUSIONS: Together with the increased number of examined samples, the rising number of strains resistant to azole antimycotics can be observed.

Hematologic Diseases↗
PubMed2004

[The first experience with linezolide in treatment of nosocomial septic condition in premature neonates].

OBJECTIVE: Nosocomial infections caused by the coagulase-negative staphylococci are among the most frequent complications in an intensive care unit for neonates. The authors describe three cases of successful treatment of this complication in which the new antibiotic Linezolide was used. DESIGN: Analysis of three clinical cases. SETTING: Mother and Child Care Institute, Prague. METHODS: Description of cases of nosocomial sepsis in 3 immature neonates where the usual treatment of multiresistant strains of coagulase-negative staphylococci, based on the use of Vankomycin, was not successful. CONCLUSION: Administration of Linezolide proved to be very effective in all of the described cases. In spite of the high effectiveness and relative safety of this preparation, its precise role in the treatment of infection-related complications caused by coagulase-negative staphylococci has not yet been established. For the time being, we recommend administering this preparation only in strictly indicated cases after the usual therapy fails.

Acetamides↗
PubMed2002

[Evaluation of trends in ue of antibiotics and resistance in selected bacterial pathogens].

BACKGROUND: Evaluation of antibiotic consumption and the surveillance of bacterial pathogens resistance appears to be an indispensable part of antibiotic policy. The aim of this study was to evaluate dynamics of antibiotics consumption and resistance development in selected bacterial strains (Pseudomonas aueruginosa, Staphylococcus aureus and Staphylococcus epidermidis) in the environment of Faculty Hospital. METHODS AND RESULTS: The analysis was focused on the development of antibiotic consumption and monitoring of the development of bacterial resistance. Samples were taken in internal and surgical departments of General Faculty Hospital in Prague in 1992, 1995, and 1999. The evaluation of antibiotic consumption was based on Anatomical Therapeutic and Chemical classification system and the Defined Daily Doses (DDD). The consumption in the follow up period almost doubled in surgical department while in internal medicine department was decreased by almost one third. In both department, namely in the surgical one significant increase of bacterial resistance of tested antibiotics was noted. CONCLUSION: The important part of the local antibiotic policy is the monitoring of development of bacterial resistance and consumption of antibiotics.

Anti-Bacterial Agents↗
PubMed1999

[Antibiotic prophylaxis of infectious complications in cesarean section--prospective study].

OBJECTIVE: To verify the significance of Cefazolin administration to women who were indicated for caesarean section. SETTING: Department of Obstetrics and Gynecology, First Faculty of Medicine, Prague, Czech republic. METHODS: Cefazolin was administered to 30 women with a patient history risk in a dose of 1 mg i.v. after ligation of the umbilical cord. The control group consisted of 30 women. Observed parameters: weight gain during pregnancy, indications for caesarean section, culture from the cervix and vagina prior to the caesarean section, culture from the amniotic fluid, culture from the 4th day lochia, temperature curve, leucocyte count before and 4 days after the operation, complications after the surgery, administration of antibiotics, and length of hospitalisation. RESULTS: In the group with antibiotic prophylaxis, we observed a more favourable course of the temperature curve and a smaller leucocyte count the fourth day after the surgery (p < 0.01), in comparison with the women without prophylaxis. The duration of hospitalisation in women with antibiotic prophylaxis was one day shorter and there was no occurrence of febrile complications requiring further antibiotic treatment. CONCLUSION: Cafazolin is advantageous antibiotic for prophylaxis in caesarean section in patients with risk.

Antibiotic Prophylaxis↗
PubMed1998

[Treatment of febrile neutropenia in patients with solid tumors].

BACKGROUND: Febrile neutropenia (FN) is one of the most serious complications of anti-tumourous treatment calling for early diagnosis and intensive treatment. The objective of the trial was to recommend a standard procedure for the treatment of febrile neutropenia at their Oncological Clinic, based on analyses of attacks of febrile neutropenia and the current microbial situation. METHODS AND RESULTS: In 1995-1997 in 30 patients (24 women, 6 men) 39 attacks of febrile neutropenia were treated. The age distribution of patients was within the range of 20-68 years, the mean age being 50 years. In the group patients with breast cancer predominated (14), soft tissue sarcomas (4), colorectal carcinoma (3), other diagnoses participated with 9 episodes. The analysis of the microbial situation was based on cultivation findings made in patients with attacks of FN. For empirical treatment of FN the authors use at combined treatment piperacillin-gentamicin or sultamicillin-cefpodoxim/or ciprofloxacin. If empirical treatment fails, therapy is based on the results of cultivation and the patient's clinical condition. Growth factors are indicated for treatment only in FN complicated by mycotic infection, inflammatory pulmonary infiltrates or cardiopulmonary failure. CONCLUSIONS: The standard procedure in the treatment of FN should be broad spectrum bactericidial antibiotics. The use of growth factors is reserved for complicated episodes of FN.

Adult↗
PubMed1997

[Antibiotic prophylaxis of infectious complications in gynecologic surgery].

Infections are still the most frequent postoperative complications and one of the limiting factors of successful gynaecological surgery. In recent years information on successful anti-microbial chemoprophylaxis is increasing and is associated with reduced postoperative inflammations, febrile morbidity and early complications. Views differ above all as regards indications for the use of antibiotic prophylaxis and the selection of a suitable antibiotic. Data in the literature differ also as regards achieved results. The submitted work had the objective to test on a representative group the success and rationality of medicamentous prophylaxis in gynaecological surgery and to contribute to a clearer view on controversial points. 203 women admitted to the Second Gynaecological and Obstetric Department of the First Medical Faculty Charles University and General Faculty Hospital Prague for elective abdominal or vaginal hysterectomy on account of a benign indication were divided into three groups which did not differ from the demographic or medical aspect. In group A (53 women) for prophylaxis two doses of Augmentin were used (combination of amoxycillin with clavulanic acid) i.v., patients in group M (50 women) had three doses of Mandol (Cefamandol) i.m., and in control group K (100 patients) no antibiotics were administered prophylactically. The authors investigated the postoperative course and evaluated some parameters in relation to possible postoperative infectious complications. The results proved unequivocally that prophylaxis with Augmentin reduces significantly the postoperative infectious morbidity (11.5%), febrile morbidity (5.6%) and the incidence of early infectious complications (3.8%) after abdominal or vaginal hysterectomy, as compared with the control group (35%, 31% and 11% resp.). Prophylaxis with Cefamandol reduced only in few parameters postoperative complications, but in general did not lead to a significant improvement of the postoperative course nor to a reduction of postoperative inflammatory complications. Similar results were obtained when only complications after abdominal hysterectomy were evaluated. The results of bacteriological examination confirmed the expected differences in the spectrum of efficacy of the two antibiotics on the most common microbial flora in the given area, i.e. a high sensitivity of Augmention to enterococci and bacterioids and resistance of these bacteria to Mandol. These results can be considered one of the reasons of different results of the two antibiotics. Prophylaxis with amoxycillin/clavulanic acid was found to be safe, very effective and financially feasible prevention of postoperative infectious complications after abdominal and vaginal hysterectomy. It led to a significant increase in the number of cases without any complications, when compared with the control group.

Amoxicillin-Potassium Clavulanate Combination↗
PubMed1995

[Results of induction therapy in newly diagnosed acute myeloid leukemias in study 911 at the Institute of Hematology and Blood Transfusion].

Thirty-seven patients with de novo acute myeloid leukemias were admitted to the Institute of Hematology and Blood Transfusion in Prague in February 1991-December 1993. Their age was 18-85 years with a median of 46 years. Two patients died on the day of admission, chemotherapy was initiated in 35 patients. Altogether 27 patients (77%) achieved complete remission (CR), i.e. 18 (81%) of 22 patients younger than 55 years and 9 (70%) of 13 patients older than 55 years. Only 7 (35%) of 20 patients achieved CR after a single therapy course 3/7 consisting of 3 doses of daunorubicin 45 mg/m2 on days 1, 3, 5 and cytosine arabinoside 150-200 mg/m2 every 12 hours for 7 days. However, 8 (61%) of 13 patients achieved CR after a single treatment course 4/7 with 4 doses of daunorubicin 45 mg/m2 on days 1, 3, 5, 7 and identical doses of cytosine arabinoside as in the 3/7 treatment. We used the course with 10 high-doses of cytosine arabinoside 2000 mg/m2 every 12 hours and daunorubicin 45 mg/m2 on days 4 and 5 (treatment HDAC/DNR) as the 1st, 2nd or 3rd induction therapy in 12 patients and 9 (75%) of them achieved CR. The treatment was associated with a high toxicity. An intensified therapy 3/7h similar to the 3/7 one but with the doubled dose of cytosine arabinoside 300-400 mg/m2 on days 5-7 was given to 5 patients as the 2nd induction but it did not improve the CR rate and it was associated with a high toxicity similar to the HDAC/DNR therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1994

[Antibiotic prophylaxis in cesarean section].

Childbirth by Caesarean section is associated with 7-10x more complications than spontaneous childbirth [28] whereby the second place is held by infection. One of the possible ways how to prevent these infectious complications is antibiotic prophylaxis. Views on the latter still differ as regards selection of the antibiotic, its effectiveness, onset of administration, dosage, period of administration etc. Prophylaxis should meet the following demands; it should be aimed, of short-term character, bactericide and non-toxic-these demands are met by cephalosporins of the second generation [11]. The objective of the present work was to evaluate the contribution of the prophylactic administration of antibiotics, i.e. a cephalosporin of the second generation-Zinacef (Cefuroxime). The group was formed by 23 women to whom a dose of Zinacef was administered after childbirth by Caesarean section and subsequently twice after 8-hour intervals (1.5-0.75-0.75 i.m.). The control group (23 women) did not have this prophylaxis. In both groups the authors compared the indication of s.c., time of loss of amniotic fluid before s.c., results of cultivations from the cervix, vagina, amniotic fluid, lochiae and sutures. The authors evaluated the postoperative course where they were interested in infectious complications, the temperature curve, period of hospitalization, the necessity to administer another antibiotic or to proceed with the antibiotic therapy after the prophylactic dose. The results are clearly in favour of the prophylactic administration of antibiotics to the risk group of patients delivering by Caesarean section.

Adult↗
PubMed1991

Computer-based evaluation of antibiotic therapy predictions.

Planning antibiotic treatment according to the given data on patients and results of microbiological examinations are important decision-making goals for physicians. One approach using a computer in medical education to improve the teaching process in this respect is described in this paper. On the basis of data about real patients and the optimal antibiotic treatment validated by the antibiotic center of the Faculty Hospital II, we can evaluate the student's abilities to predict correct antibiotic treatment. The general program written for this task and the method of evaluating the student's predictive skills are described.

Anti-Bacterial Agents↗
PubMed1988

The effect of antimicrobial prophylaxis for thoracic noncardiac surgery: thienamycin versus cefazolin.

A comparison was made of the use of thienamycin and cefazolin in antimicrobial prophylaxis of patients undergoing major thoracic noncardiac surgery. Fever and failure or success of prophylaxis were used as criteria. Both cefazolin and thienamycin were of the same value in cases of lung resections, while thienamycin was clearly superior in resections of thoracic oesophagus.

Bacterial Infections↗