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D Milatovic

Publications and source records attributed to D Milatovic.

At least 73 records · Page 4Linked to original sources
PubMed1993

[Quantitative study of vaginal flora during the menstrual cycle].

The aerobic and facultatively anaerobic vaginal flora of 242 healthy women were examined during menstrual cycles. The most frequently isolated microorganisms at the first premenstrual examination were coagulase-negative staphylococci (61%), followed by enterococci (25%), Gardnerella vaginalis (19%), diphtheroids (12%), group B streptococci (6.8%), Escherichia coli (5.4%) and Candida spp. (4%). The isolation rate of all species, except Candida and Gardnerella vaginalis increased during menstruation. The lowest isolation rate for Staphylococcus aureus was 0.9% prior to menstruation and it increased to 7.6% during menstruation. This may be of relevance with regard to the toxic shock syndrome. Gardnerella vaginalis was isolated in 37% of women at least once during the study, suggesting, that this species belongs to the normal vaginal flora.

Adolescent↗
PubMed1993

Cefprozil versus penicillin V in treatment of streptococcal tonsillopharyngitis.

In a randomized multicenter study, the efficacy and safety of cefprozil were compared with those of penicillin in the treatment of group A streptococcal tonsillopharyngitis in children. Of the 409 patients enrolled, 323 were evaluable for their clinical and bacteriological responses; of these 323 children, 172 received cefprozil and 151 received penicillin V. The clinical responses in patients treated with cefprozil were significantly better than those in patients who received penicillin (95.3 versus 88.1%; P = 0.023). Eradication of the original serotype of group A streptococci was achieved in 91.3% of patients treated with cefprozil and 87.4% of patients treated with penicillin, the difference not being statistically significant (P = 0.125). However, there were significantly more symptomatic patients among the bacteriological failures in the penicillin group (68.4%) than in the cefprozil group (26.7%). beta-Lactamase-producing Staphylococcus aureus was more frequently isolated from the throat flora during penicillin therapy than during cefprozil treatment. No difference in the incidence of adverse events probably related or of unknown relationship to the study drugs was observed in the two treatment groups (5.2% of those treated with cefprozil and 6.0% of those treated with penicillin). Cefprozil can be considered a safe and reliable drug for the treatment of streptococcal pharyngitis in children.

Cephalosporins↗
PubMed1993

[Evaluation of the serum bactericidal test].

The serum bactericidal test (SBT) is used to monitor antibiotic treatment during therapy. Compared to other methods of sensitivity testing, such as MIC (minimum inhibitory concentration) determination, the SBT also takes into consideration the pharmacokinetic qualities of the drug tested. Serum bactericidal titers are measured during therapy of different infectious diseases to estimate therapeutic outcome. Until now serum bactericidal titers of 1:8 in non-granulocytopenic patients, and titers > or = 1:16 in granulocytopenic patients have been shown to correlate with a successful treatment outcome in patients with gram-negative sepsis. In patients with endocarditis a peak serum bactericidal titer of at least 1:32 should be achieved. Another way to apply the serum bactericidal test is to compare the activity of different antibiotics in volunteers. The present study as well as data from the literature indicate that ciprofloxacin has markedly higher serum bactericidal activity than ofloxacin. Of the so called "basic cephalosporins" cefotiam achieved the highest serum bactericidal activity against the Enterobacteriaceae tested. Since 3rd generation cephalosporins are in general highly active against gram-negative rods, we were interested in using the SBT to compare different dosage regimens. In several studies serum bactericidal titers of > or = 1:8 were achieved with the 1 g dosis of cefotaxime, cefmenoxime and especially ceftazidime against the gram-negative rods tested.

Agranulocytosis↗
PubMed1992

[Incidence, frequency and resistance characteristics of methicillin-oxacillin resistant Staphylococcus aureus strains in Germany].

In a multicentre study, the methicillin-resistant Staphylococcus aureus (MRSA) isolates in 19 large clinics in Germany were recorded, and the resistance characteristics of these strains were studied. Oxacillin-mannitol-salt agar plates were distributed to all participants to ensure uniformity of screening, and each laboratory used these plates to investigate 200 consecutive Staphylococcus aureus isolates for oxacillin-methicillin resistance. Of the 3,794 evaluable Staphylococcus aureus isolates, 71.5% were penicillin and 3.7% (142) oxacillin resistant; four study centres reported methicillin-oxacillin resistance rates of more than 5%. Of the MRSA isolates, 75% were also resistant to ciprofloxacin, 61% to fosfomycin, 52% to imipenem, 50% to trimethoprim/sulfamethoxazole and 36% to clindamycin. All isolates were sensitive to vancomycin and teicoplanin. Of the Staphylococcus aureus strains isolated from patients in intensive therapy units, 10.4% were methicillin-oxacillin resistant. Drains and catheter tips (9.8% and 5.2% respectively) were the materials with the highest proportions of MRSA. Of the MRSA isolates in this study, 58.2% belonged to lysis group II.

Ciprofloxacin↗
PubMed1992

[Evaluation of the so-called basic cephalosporins using the serum bactericidal test].

The serum bactericidal activity (SBA) was studied one hour and four hours after intravenous administration of 1 g and 2 g cefotiam, 1.5 g cefuroxime and 2 g cefazolin to six volunteers. The 136 clinical isolates tested included Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis and Haemophilus influenzae. One hour after administration no significant differences in the activity against staphylococci were noted in the antibiotics tested. Four hours after administration of cefazolin 96% of the Staphylococcus aureus strains were killed at a serum dilution of 1:8, whereas only one strain was killed by cefuroxime and none by cefotiam under the same conditions. The highest SBA-titers against Haemophilus influenzae were achieved with cefotiam at a dosage of 2 g. SBA-titers against Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis were higher after administration of 1 g cefotiam than after administration of 1.5 g cefuroxime and 2 g cefazolin, respectively.

Blood Bactericidal Activity↗
PubMed1992

Efficacy of fluconazole in the treatment of systemic fungal infections.

The efficacy of fluconazole in the treatment of systemic fungal infections was evaluated in an open non-comparative trial. A total of 48 patients with proven or suspected fungal infections were enrolled in 40 of whom efficacy was evaluable. Candida albicans accounted for 90% of the infections. Candida parapsilosis, Candida glabrata, Histoplasma capsulatum and Aspergillus fumigatus caused the infection in one case each. Fluconazole was administered at a dosage of 200-400 mg daily for a mean duration of 15 days. Fluconazole treatment was successful in 53% of the patients. In patients with proven or probable Candida albicans infections a clinical and mycological response was achieved in 62% and 65%, respectively. In 11 patients elevation of liver enzymes was considered to be possibly related to fluconazole treatment; modification of treatment was not necessary in any case. Fluconazole was found to be a well tolerated and effective agent for the treatment of systemic Candida albicans infections.

Adolescent↗
PubMed1992

Influence of OM-85 BV on different humoral and cellular immune defense mechanisms of the respiratory tract.

To clarify the mode of action of an oral bacterial extract (OM-85 BV) on local airway immunity pre- and posttherapeutic washings from bronchoalveolar lavage (BAL) fluid of 28 adult patients with nonobstructive chronic bronchitis were analysed. In comparison to healthy controls, an elevation of total cell count due to an increased number of PMN leukocytes, and an impaired activity of the alveolar macrophages measured by the chemiluminescence response to opsonized zymosan was observed in patients with chronic bronchitis. After treatment with OM-85 BV, the BAL CD4+/CD8+ lymphocyte ratio and BAL interferon-gamma levels were increased. The alveolar macrophage activity was normalized and the BAL IgA was regulated from a reduced or hyperelevated to a moderately increased level.

Adjuvants, Immunologic↗
PubMed1990

Intraphagocytic activity of erythromycin, roxithromycin and azithromycin.

The intraphagocytic activity of erythromycin, roxithromycin and azithromycin against phagocytosed Staphylococcus aureus was compared. Erythromycin and roxithromycin both acted bacteriostatically at concentrations corresponding to 10 X MIC. Azithromycin, however, did not prevent intracellular proliferation of the staphylococci. On comparison of the pH dependency of the antibacterial activity of the three drugs, azithromycin was found to be inactivated earlier in an acidic milieu.

Azithromycin↗
PubMed1990

Effects of a bacterial extract on local immunity of the lung in patients with chronic bronchitis.

Our findings demonstrate that Broncho-Vaxom (BV) displays possibly via the gut-associated immune system different effects on the lymphatic system of the lung: a positive influence on the helper/suppressor T-lymphocyte balance, an increase of gamma interferon, a stimulation of the reduced alveolar macrophage activity, and a regulation of BAL IgA to a distinct level whereby the serum IgE is reduced. By these effects BV is able to modulate impaired local and systemic immune function. The observed relationship between the inflammation score and the BAL fluid composition supports the view that the improvement of the mucosa lesion found in nearly all of our patients with chronic bronchitis occurs as the result of the pleiotropic immunomodulating effects of Broncho-Vaxom.

Adjuvants, Immunologic↗
PubMed1990

Local immunity in patients with chronic bronchitis and the effects of a bacterial extract, Broncho-Vaxom, on T lymphocytes, macrophages, gamma-interferon and secretory immunoglobulin A in bronchoalveolar lavage fluid and other variables.

In 28 adult patients with nonobstructive chronic bronchitis we investigated components of the immune system of the lower airways and the effects of treatment with Broncho-Vaxom (BV). An analysis of the washing from bronchoalveolar lavage (BAL) showed, in comparison with healthy controls, an elevation of total cell count (p = 0.003) as well as the IgA/albumin values (p = 0.02) and a reduction of the macrophage activity (p less than 0.001) in patients with chronic bronchitis. After BV a reduction in the total cell count (p = 0.05), an increase in the helper/suppressor T lymphocyte ratio (due mainly to the reduction in the suppressor cells; p = 0.04), a modulation of the IgA/albumin ratio, a stimulation of the impaired alveolar macrophage activity (p = 0.03) and increased concentrations of gamma-interferon (p = 0.03) were found in the BAL fluid of patients with chronic bronchitis. The salivary IgA/albumin ratio remained unchanged, the serum IgE concentration fell (p = 0.02) and the urinary IgA concentration rose (p = 0.002). Bronchial mucosa lesions, evaluated endoscopically in terms of structural damage, hyperemia and mucus production, were improved (p less than 0.01). These findings indicate that orally administered BV modulates disordered local and systemic immune functions in patients with chronic bronchitis.

Adjuvants, Immunologic↗
PubMed1989

Cefadroxil versus penicillin in the treatment of streptococcal tonsillopharyngitis.

In a randomized multicentre study the efficacy of phenoxymethyl-penicillin and cefadroxil was tested in the treatment of acute tonsillopharyngitis caused by group A streptococci. These organisms were detected in 269 of the 300 children studied. Of the 239 patients in whom results could be evaluated, 121 received penicillin and 118 cefadroxil. After ten days of therapy the microbiological failure rate was 19% in the penicillin group and 6.8% in the cefadroxil group (p less than 0.01). Ten of 23 cases of microbiological failure in the penicillin group and two of eight in the cefadroxil group also had clinical symptoms of infection. All streptococcal isolates were sensitive to penicillin, cefadroxil and clindamycin with the exception of one strain with intermediate sensitivity to cefadroxil. Seven strains had intermediate sensitivity to erythromycin and one was resistant. No penicillin tolerance was observed. Patients in whom penicillin therapy failed more frequently had beta-lactamase producing staphylococci in the pharyngeal flora in comparison to successfully treated patients. The clinical and bacteriological results showed that cefadroxil was clearly superior to penicillin.

Adolescent↗
PubMed1987

Development of resistance during antibiotic therapy.

The frequency of development of resistance during antibiotic therapy was evaluated by reviewing the literature according to prescribed criteria. Mean resistance rates were calculated to be 9.2% for broad spectrum penicillins, 8.6% for second and third generation cephalosporins, 10.0% for latamoxef, 4.7% for imipenem, 11.8% for ciprofloxacin and 13.4% for aminoglycosides. Emergence of resistance of the infecting organism was associated with therapeutic failure in about half of the cases with the exception of patients treated with aminoglycosides in whom development of resistance resulted in treatment failure in 85% of the cases. The possible benefit of combination therapy in terms of resistance development is discussed.

Anti-Bacterial Agents↗
PubMed1987

Serum bactericidal activity of ciprofloxacin and ofloxacin in volunteers.

The serum bactericidal activity of two newer quinolones, ciprofloxacin and ofloxacin, against 206 clinical bacterial isolates was determined in six male volunteers after oral administration of either 500 mg of ciprofloxacin or 200 mg of ofloxacin respectively. The highest bactericidal titers were achieved against Enterobacteriaceae 1 h after ciprofloxacin administration, ranging from 1:121 for indole-positive Proteus species to 1:30 for Serratia spp. Ofloxacin generated lower titers, ranging from 1:14 for indole-positive Proteus spp. to 1:2.5 for Enterobacter spp. Only low serum bactericidal titers were found for Pseudomonas aeruginosa, Acinetobacter spp. and gram-positive cocci. It is concluded that the activity of orally administered ciprofloxacin is superior to that of orally administered ofloxacin in the serum bactericidal test.

Administration, Oral↗
PubMed1986

Evaluation of novel antipseudomonal drugs using the serum bactericidal activity test.

Serum bactericidal activity against Pseudomonas aeruginosa was determined in six volunteers 1 and 4 h after administration of 2 g ceftazidime, 4 g piperacillin, 500 mg imipenem, 80 mg tobramycin and four combinations of these agents. Ceftazidime produced the highest serum bactericidal titers, killing 100% and 86% of the 50 Pseudomonas aeruginosa strains tested after 1 and 4 h respectively at a serum dilution of 1:8. Imipenem had lower serum bactericidal titers than ceftazidime, killing 88% of the isolates after 1 h at a serum dilution of 1:8. The combination showed only slightly higher titers. Killing curves were determined for nine strains of Pseudomonas aeruginosa using undiluted volunteer serum drawn 1 h after administration of the antibiotics. The combinations ceftazidime/tobramycin and piperacillin/tobramycin exhibited higher killing activity than the single drugs. As the activity of the aminoglycosides could be underestimated on the basis of their low serum bactericidal titers, it is concluded that determination of these titers is inappropriate for evaluating the efficacy of the aminoglycosides.

Ceftazidime↗