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Biomedical subjects

D H Wittmann

Publications and source records attributed to D H Wittmann.

At least 55 records · Page 3Linked to original sources
PubMed1985

The efficacy of cefotaxime in gram-positive surgical infections.

In order to evaluate the efficacy of cefotaxime in gram-positive surgical infections, three clinical studies were re-evaluated. Antibiotic susceptibility tests were carried out on clinical isolates from our hospital during the period of clinical use of cefotaxime. The tissue fluid concentrations measured were compared to minimal inhibitory concentrations of gram-positive pathogens. Following 2 g cefotaxime i.v., tissue fluid concentrations were higher than 8 mg/l for more than 6 h and higher than 4 mg/l for more than 8 h. More than 90% of gram-positive pathogens excluding enterococci were inhibited at 4 mg/l. A comparison was made on the clinical efficacy of cefotaxime on infections caused by gram-positive organisms (group I) versus infections due to gram-negative bacteria (group II). 89 patients entered this study. In 40 patients only gram-positive bacteria were isolated initially (group I) and in 49 mainly gram-negative bacteria (group II). The mean age was 43 years (range 8-80 years) in group I and 61 years (range 19-92 years) in group II. Most patients received 2 g cefotaxime every 12 h. 40 skin and soft tissue infections (group I = 25, group II = 15), 25 pulmonary infections (group I = 7, group II = 18), 17 biliary infections (group I = 4, group II = 13) and nine bone and joint infections (group I = 4, group II = 5) were treated. The mean duration of therapy was nine (group I) and 11.2 (group II) days. Surprisingly, the cure rate was better in group I (70%) than in group II (59%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1983

[Use of hydroxyapatite for determination of antibiotic concentrations in bone].

A new method to determine antibiotic bone concentrations is presented. The bone fragments, obtained during hip joint replacement operations in 10 patients were investigated for antibiotic activity after i.v. application of 2 g of oxacillin and 4 g of mezlocillin. We were able to show that both penicillins do not penetrate into the inorganic bone part (hydroxylapatite). Therefore the concentrations measured are related to the organic bone part and are expressed in units per volume rather than in units per weight. With this method the differences between spongious and cancellous bone observed so far are diminished to values without any statistical difference. After 2 g of oxacillin and 4 g of mezlocillin the concentrations are 13.1 mg/l and 34.0 mg/l, respectively. The serum concentrations measured are compared to the bone concentrations. The terminal serum half-life is 63 min for oxacillin and 80 min for mezlocillin when the drugs are given simultaneously.

Aged↗
PubMed1983

[Infection prevention in elective large intestine surgery. Results of a prospective randomized comparative study].

In a prospective randomized trial clinical results of orthograde bowel lavage alone (group I) versus combined bowel lavage and parenteral antibiotic prophylaxis with 4 gm Cefoxitin (group II) in two separate dosages (perioperative short-term-prophylaxis) are compared with regard to the reduction of septic complications after colorectal surgery. Septic wound complications were 11/27 = 41% in group I and 2/30 = 7% in group II. The rate of anastomotic leakages was significantly different in the two groups (5/27 in group I, 0 in group II). The monetary costs for given antibiotics and the duration of hospitalization were less in group II. Orthograde bowel lavage alone proved to be of no effect in reducing the rate of septic complications when used without antibiotic perioperative short-term-prophylaxis and therefore cannot be recommended to be used solely.

Aged↗
PubMed1982

[Pharmacokinetic investigations on the penetration of mezlocillin into the pleural fluid].

5 g of mezlocillin were administered by a 30 minute drip infusion to each of ten patients (mean age 59.4 years). Antibiotic concentrations in serum and pleural fluid were assayed microbiologically at regular intervals. The antibiotic concentrations determined 1.5 and 8 hours after beginning the infusion were between 83.9 and 4.0 mg/l in the serum and 53.1 and 6.5 mg/l in the pleural fluid. A comparison of the mean antibiotic concentration found in the pleural secretions (22 mg/l) with the minimal inhibitory concentrations of clinically relevant pathogens shows that mezlocillin covers 69% to 84% of the pathogen spectrum. Mezlocillin can thus be used in the therapy of infectious pleural effusions.

Aged↗
PubMed1982

[Antibiotic concentrations in the abdominal cavity as basis for antibacterial therapy of peritonitis: penetration of mezlocillin into the peritoneal exudate].

The importance of the antibiotic concentration in peritoneal exudate is emphasized as a criterium for the possible success of antibiotic therapy of intra-abdominal infections. 5 g of mezlocillin were given i. v. over 15 min to ten patients with a mean age of 56 years. The serum concentrations, assayed microbiologically, were: 299.5 mg/l at the end of the infusion, 103.2 mg/l, 18.6 mg/l and 2.1 mg/l 60, 240 and 480 min after the end of the infusion, respectively. The serum half-life T1/2 beta, calculated from the beta phase, was 67 min. In the peritoneal fluid the peak concentration of Cp = 42.0 mg/l was achieved after 2.2 h. A quarter of this concentration was maintained in the peritoneal cavity for five to six hours. This concentration inhibited 74% of the 322 pathogens isolated from 123 intra-abdominal infections.

Ascitic Fluid↗
PubMed1982

The pathologic implication of duodenal diverticula.

In a prospective study of 80 patients with duodenal diverticula and calculous biliary tract disease, bacteriocholia with typical intestinal bacteria was found in 51 of 71 patients, whereas, in cholelithiasis without duodenal diverticula, this complication was present in 278 of 809 patients. With an increasing distance between duodenal diverticula and the papilla of Vater, the rate of bacteriocholia decreases. Advancing age of the patients results in the augmentation of bacteriocholia. Bacteriocholia on the basis of duodenal diverticula seems to present an additional pathogenic factor for inflammatory biliary tract disease and pancreatitis. Consequently, the pathologic value of juxtapapillary duodenal diverticula is much more prominent than has so far been reported.

Age Factors↗
PubMed1981

[The penetration of moxalactam into bone (author's transl)].

After injection of 2 g of moxalactam over 5 minutes in 8 patients with mean age of 71,5 years, serum halflife was found to be T 50% beta = 184 min and the volume of distribution at steady state VDSS = 17,45l, whereas these figures in volunteers with mean age of 22.8 years were T 50% beta = 134 min and VDSS 16,80l respectively. The concentrations in organic bone were 30 to 60 min after injection of 2 g of Moxalactam 19,40 mg/l with a deviation factor of 1,43 and 61 to 120 min after injection 19,08 mg/l with a deviation factor of 1,16. The problems of penetration of antibiotics into bone are discussed. Moxalactam does not penetrate into anorganic bone (hydroxylapatite).

Aged↗
PubMed1981

[Pharmacokinetic studies on the penetration of azlocillin and mezlocillin into bone and tissue fluid (author's transl)].

During and after hip replacement arthroplasty antimicrobial concentrations in serum, bone and tissue-fluid were determined microbiologically using agar diffusion assay technique after 15-min infusion of 5 g 6-[D-2-(2-oxoimidazolidine-1-carboxamido)-2-phenylacetamido] - penicillanic acid (azlocillin) and 5 g 6-[D-2-(3-methylsulfonyl-2-oxoimidazolin-1-ylcarboxamido)-2-phenylacetamido]-penicillanic acid (mezlocillin) and after i.v. bolus injection of 2 g mezlocillin. Serum pharmacokinetic data on the individual patients are computer derived using a modified open two-compartment model. The geometric mean of bone level determinations at defined intervals with deviation factor are presented. These results are related to the organic bone compartment and are expressed in mg/l. From the tissue fluid-concentration curve, peak concentration CP and its time were calculated. The time for which one-fourth of the peak concentration CP 1/4 was maintained in tissue fluid was determined graphically. This concentration is compared with the cumulative minimum inhibitory concentrations of representative bacteria causing bone and joint infections. These results are focused as criteria of valuation of antimicrobial chemotherapy.

Aged↗
PubMed1980

[Availability of cefotaxime. Pharmacokinetic studies on the distribution in central and various peripheral compartments (author's transl)].

After 2 g as a bolus injection the concentration of Cefotaxime was determined in serum, bone, tissue fluid, peritoneal exudate and bile under clinical conditions in 43 patients with a mean age of 61 years. Pharmacokinetic constants were calculated using a modified two compartment model. The basis for these calculations was a mean serum curve from 299 serum samples. The geometric mean and deviation factors of time-dependent values in tissue and tissue fluid are presented. The results are compared to the minimal inhibitory concentrations of pathogenic bacteria. The clinical success in 121 severe infections at a dose of 2 g every 12 hours support the theoretical results of this study.

Ascitic Fluid↗
PubMed1977

[The significance of intraoperative bacteriological findings in operations on the gallbladder and biliary tract (author's transl)].

The symptomless bacterial contamination of the biliary tree is apt to be the origin of general or local postoperative complications. The present retrospective study of 369 bilary operations with intraoperative bacteriologica investigations yielded the following results: septic wound complications were found in 9% of the cases with bacteriocholia against 3.5% in the cases with abacterial bile. In geriatric patients with complicated gallstone disease the bacterial contamination of the bile exceeds 50% of all cases. The importance of an adequate antibiotic treatment for this group, starting intraoperatively, is stressed.

Adult↗