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Biomedical subjects

E B Helm

Publications and source records attributed to E B Helm.

At least 91 records · Page 5Linked to original sources
PubMed1982

Elimination of bacteria in biliary tract infections during ceftizoxime therapy.

A transpapillary indwelling catheter was inserted to prevent stone impaction in six female patients who were suffering from choledocholithiasis. The bile withdrawn via the catheter was infected on six occasions with Escherichia coli. In one of these cases Klebsiella sp. and in another Salmonella sp. were also identified. All bacteria were sensitive to ceftizoxime (the MIC was between 0.007 and 0.06 mg/l). The bacterial counts in the bile were determined before and during treatment by means of membrane filtration. In all six cases there was a rapid decline in the colony count. The concentration of ceftizoxime in bile samples was several times higher than the MIC of ceftizoxime for the corresponding pathogens. Overall, the therapeutic results with ceftizoxime were good. Three of eight pathogens were eliminated from the bile within eight to 24 hours. In one case a change of pathogen was seen after 24 hours. Forty-eight hours after beginning treatment, four of eight pathogens had been eliminated from the bile. After 72 hours the colony count in six patients was less than 10 pathogens/ml. In two patients a change of pathogen occurred; in one patient treatment had to be stopped after the first injection because of urticaria.

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PubMed1981

[Bacterial elimination and antibiotic concentration in the gall-bladder during biliary tract infections treated with mezlocillin (author's transl)].

A transpapillary indwelling catheter was placed in 15 patients with choledocholithiasis and threatened occlusion by stone. Ten of the 15 patients had marked biliary stasis, four had signs of acute cholangitis. In all patients E. coli was present in the gall-bladder in a concentration of greater than or equal to 10(5)/ml when the catheter was first inserted. The bacteria were sensitive to mezlocillin, at a minimal inhibitor concentration between 1.5 and 16 micrograms/ml. All patients received mezlocillin, 5 g twice daily, in a short-term infusion. Immediately before and regularly thereafter bile samples were taken to measure antibiotic concentration and bacterial counts (by membrane filtration). Mezlocillin was excreted in the bile in very high concentrations in patients without biliary stasis. But while the concentrations were markedly lower in those with stasis, they were still 10 to 100 times the minimum inhibitory concentration of mezlocillin against the appropriate strains. In keeping with the high mezlocillin concentration, bacterial counts fell much more quickly in the patients without stasis than in those with alkaline phosphatase concentration above 250 U/l. These differences were even more marked after two or three days. Bacterial elimination from bile was complete in two of three patients with normal alkaline phosphatase activity, but in only one of five in whom it was elevated.

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PubMed1981

Alternating treatment of common bile duct stones with a modified glyceryl-1-monooctanoate preparation and a bile acid-EDTA solution by nasobiliary tube.

Twenty patients with bile duct stones were treated via an indwelling nasobiliary tube with a modified Capmul 8210 preparation (GMOC) and alternating with a bile salt-EDTA (BA-EDTA) solution for an average of 12 days. In vitro the dissolution capacity of GMOC and BA-EDTA for cholesterol stones was higher than that of Capmul 8210. The nasobiliary tube was tolerated well for a maximum of 84 days; this renders us independent of the T-tube. The therapeutic success rate of GMOC was 64%, even though we treated mostly old and large concrements. Side effects occurred markedly less than with Capmul 8210. In patients with acute cholecystitis or cholangitis the clinical course improved under therapy, and there was no deterioration of a chronic condition.

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PubMed1979

[Pathogen elimination after surgical interventions on common bile duct (author's transl)].

Of 130 bile samples from the choledochus, 64% were positive for bacteria. Different antibiotics were administered according to the susceptibility tests. Colony counts were monitored daily. Beta-lactam antibiotics lead to a more rapid pathogen clearance than the tetracyclines. Antibiotic therapy is discussed especially in older patients and in patients with recurrent interventions on common bile duct. Bile cultures were positive in most of these patients.

Adult↗
PubMed1979

Elimination of bacteria during antibacterial chemotherapy--a neglected parameter of chemotherapy.

In 25 patients with urinary tract infections (pathogen Escherichia coli), colony counts from bacteria in the urine were done before and after treatment with antibiotics. Both 800 mg bacampicillin and ampicillin have a higher bactericidal effect in urine than co-trimoxazole. Patients with acute urinary tract infections given 400 mg bacampicillin and patients with chronic infections given double that dosage showed equally good results. In uncomplicated urinary tract infections with sensitive strains treated with cefotaxime, the colony count was reduced markedly faster than in infections in patients with kidney insufficiency or infection with multiresistant strains. The reduction of the colony count from the urine of patients with urinary tract infections and multiresistant strains during treatment with antibiotics is an important criterion in the evaluation of antibiotics. Such tests should supplement the customary sensitivity checks of antibiotics, the MIC and the agar diffusion test in the early phases of clinical trials.

Adult↗