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D Stamboulian

Publications and source records attributed to D Stamboulian.

7 recordsLinked to original sources

[Analysis of urinary infection in the 1st month after kidney transplantation. Value of short prophylaxis with norfloxacin].

Urinary tract infection is the most common complication in the first month after renal transplant, and it is associated with rejection and relapses. In addition, it is the leading cause of gram negative bacilli bacteremia. In a program of continuous epidemiological surveillance from March 1979 to October 1988, we evaluated the urinary tract infections in the first month after renal transplant, considering the following variables: duration of bladder catheterization, urologic complications, type of immunosuppression and preoperative and postoperative antibiotic prophylaxis. There were no differences between the development of urinary tract infections in relation with the duration of bladder catheterization (7 vs 4 days), the reduction of urologic complications (21 vs 6%), or with the introduction of cyclosporin to the conventional immunosuppressive regimen. However, when the group of 46 patients receiving postoperative antibiotic prophylaxis (norfloxacin 800 mg/day every 12 h during the time of vesical catheterization less than or equal to 4 days) was compared with the 147 without postoperative antibiotic prophylaxis, the rate of urinary tract infection in the first month was 8.7% vs 32.8%, respectively (p less than 0.01). Short-term prophylaxis with norfloxacin was a useful regimen, with good oral tolerance and a similar therapeutic efficacy as the sustained regimens reported in the literature.

Adolescent

Antibiotic management of outpatients with endocarditis due to penicillin-susceptible streptococci.

Thirty patients with endocarditis caused by penicillin-susceptible streptococci were enrolled in one of two groups in this study. Fifteen patients received ceftriaxone (2 g once daily) for 4 weeks; the other 15 received the same dosage of ceftriaxone for 2 weeks and then received oral amoxicillin (1 g four times a day) for 2 weeks. For the 27 patients treated predominantly as outpatients, 380 days of hospitalization were avoided. Clinical cure was achieved for all patients in both groups. We conclude that ceftriaxone, alone or followed by a course of amoxicillin, is an efficacious mode of treatment for infective endocarditis caused by penicillin-susceptible streptococci. Treatment with these agents can be administered predominantly on an outpatient basis.

Administration, Oral

Comparative clinical evaluation of imipenem/cilastatin vs. cefotaxime in treatment of severe bacterial infections.

Adult patients with severe bacterial infections caused by organisms susceptible to imipenem and cefotaxime were given either imipenem/cilastatin sodium (MK0787/MK0791) or cefotaxime as a part of a multiclinic randomized study to evaluate the effectiveness, safety, and tolerability of imipenem/cilastatin. Clinical diagnoses included bacteremia, urinary tract infection, osteomyelitis, mediastinitis, lower respiratory tract infection, and soft tissue infection. Efficacy was evaluated for 10 patients given imipenem/cilastatin and for 10 patients given cefotaxime. Major pathogens isolated included Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Klebsiella species, Streptococcus pneumoniae, Bacteroides fragilis, and Peptostreptococcus species. Satisfactory clinical responses were noted in 90% of the patients in both treatment groups. Eradication of the pathogen was achieved in nine of 10 patients treated with imipenem/cilastatin and in 10 of 10 patients treated with cefotaxime. No major adverse effects were found in patients in each treatment group. The results of this study suggest that imipenem/cilastatin sodium is a relatively safe and effective antibiotic for the treatment of adult patients with severe infections caused by susceptible organisms.

Adolescent