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Biomedical subjects

F D Daschner

Publications and source records attributed to F D Daschner.

At least 181 records · Page 10Linked to original sources
PubMed1980

Investigations of cefuroxime levels in cerebrospinal fluid of patients with and without meningitis.

Cefuroxime was given to 5 neurosurgical patients intravenously in intervals of 8 h. Serum and cerebrospinal fluid (CSF) concentrations were determined periodically over severaly days. Our results (72 CSF and serum concentrations) show that cefuroxime penetrates the blood CSF barrier to the same low degree as the previously used cephalosporins. In patients with noninflamed meninges the maximum CSF concentration amounted to 0.09 microgram/ml, in patients with meningitis the maximum concentration amounted to 8.28 micrograms/ml. Although these concentrations were achieved, we would recommend cefuroxime only then, if pathogens isolated from CSF are resistant to chloramphenicol and ampicillin or if patients have a penicillin allergy. Cefuroxime is not a suitable drug for perioperative chemoprophylaxis in neurosurgery as used for certain operations.

Adult↗
PubMed1979

In vitro efficacy of Bay k 4999, a new ureido-penicillin, in combination with aminoglycosides against Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae and Proteus strains.

The in vitro effects of Bay k 4999 in combination with gentamicin, tobramycin, amikacin sisomicin and netilmicin in bacteriostatic (MIC) and bactericidal (MBC) concentrations were compared using the checkerboard dilution technique against 20 different strains of Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae and indole-positive-negative Proteus species. On average 63% of Bay k 4999-aminoglycoside (AG) combinations inhibited Pseudomonas, Proteus and Klebsiella strains additively and/or synergistically in bacteriostatic as well as in bactericidal concentrations as compared to only 14% additive or synergistic activity on E. coli. 35% of the combinations tested proved to be synergistic in K. pneumoniae, 20% in Proteus, 13% in Pseudomonas, but only 5% in E. coli. No significant differences between various Bay k 4999-AG combination effects could be demonstrated.

Amikacin↗
PubMed1976

[Combination of bacteriostatic and bactericidal drugs: lack of significant in vitro antagonism between penicillin, cephalothin, and rolitetracycline].

Although it is generally believed that bactericidal and bacteriostatic drugs should not be combined in vivo, in vitro experiments using the checkerboard dilution technique revealed no antagonism between penicillin/cephalothin and rolitetracycline but rather additive or synergistic activity of either drug combination in 40 to 50% of 20 Escherichia coli, and 14 Staphylococcus aureus strains. Slight antagonism occurred only between 3 and 8 h after combining penicillin/cephalothin and rolitetracycline in either bacteriostatic or bactericidal concentrations, but not after 24 h of incubation, nor was antagonism found with combinations of these drugs in bacteriostatic concentrations. Neither bacteriostatic nor bactericidal activity of penicillin/cephalothin and rolitetracycline was inhibited by pretreatment of one E. coli strain with bacteriostatic rolitetracycline or bacteriostatic penicillin/cephalothin concentrations. Penicillin and cephalothin could exert a bactericidal effect after 2-h exposure of the E. coli strain to bacteriostatic rolitetracycline concentrations. Combined action of subinhibitory penicillin and rolitetracycline concentrations resulted in more pronounced inhibition of growth than either drug alone. The higher activity of penicillin/cephalothin in combination with rolitetracycline on some E. coli and S. aureus strains might be due to a better access of rolitetracycline into bacterial cells whose cell walls have been weakened by cell wall-active, bactericidal drugs. Thus, growth of penicillin-induced spheroplasts of E. coli and stable staphylococcal L-forms was inhibited by much lower concentrations of rolitetracycline than were the corresponding parent cells with intact cell walls.

Cephalothin↗
PubMedDate not supplied

In vitro activity of sulbactam plus ampicillin against hospital isolates of coagulase-negative staphylococci and Acinetobacter species.

The antimicrobial susceptibility of 54 recent clinical isolates of coagulase-negative slime- and non-slime-producing staphylococci and 52 Acinetobacter spp. to sulbactam, ampicillin and the combination of both drugs with a 1:1 ratio was studied by means of an agar dilution test. The coagulase-negative staphylococci showed resistance against sulbactam alone, whereas ampicillin as a single agent was nearly as active as sulbactam plus ampicillin (mode of MIC and MBC 0.03 and 4 mg/l vs. 1 mg/l; geometric mean of MIC and MBC 0.38 and 0.56 vs. 0.26 and 0.38 mg/l, respectively). Among slime-producing or non-slime-producing strains, there was no difference in the susceptibility against ampicillin alone compared to the sulbactam/ampicillin combination, with the exception of the higher MBC (mode: 4 mg/l) for slime-producing strains. Both ampicillin and the sulbactam/ampicillin combination were more active against non-slime-producing than slime-producing strains with modes of MIC and MBC of 0.03 vs. 1 or 4 mg/l. Acinetobacter spp. were susceptible to sulbactam alone (mode of MIC and MBC 1 mg/l; geometric mean of MIC and MBC 1.51 and 2.98, respectively), but resistant to ampicillin. However, the sulbactam/ampicillin combination was highly active against Acinetobacter spp. (mode of MIC and MBC 0.5 and 2 mg/l; geometric mean of MIC and MBC 0.74 and 2.08 mg/l, respectively).

Acinetobacter↗
PubMedDate not supplied

Combination effect of SCE-2787 and cefepime with aminoglycosides on nosocomial gram-negative bacteria.

The in vitro activity of cefepime and SCE-2787, two new parenteral cephalosporins, and the combination effect with tobramycin and gentamicin against nosocomial gram-negative rods was studied using checkerboard agar dilution technique. Cefepime showed excellent in-vitro activity against Klebsiella pneumoniae, Enterobacter cloacae, Serratia marcescens and Proteus vulgaris (MIC90 0.03-0.125 mg/l) and good to moderate activity against Acinetobacter anitratus, Pseudomonas aeruginosa and Pseudomonas cepacia (MIC90 4-16 mg/l). SCE-2787 had an excellent activity against Citrobacter spp. (MIC90 0.125 mg/l) and a very good activity against A. anitratus, P. aeruginosa and P. vulgaris (MIC90 1-2 mg/l). Pseudomonas maltophilia was not inhibited at therapeutically achievable concentrations (MIC90 64 mg/l). On average, 14-28% of the strains were inhibited by synergistic SCE-2787 aminoglycoside-combinations, whereas only 8.6% were inhibited by a synergistic effect of the combination with cefepime and gentamicin. No antagonism occurred with any of the combinations.

Anti-Bacterial Agents↗
PubMedDate not supplied

Antibiotic usage in community-acquired pneumonia: results of a survey in 288 departments of internal medicine in German hospitals.

In 1989 a survey was conducted in 800 medical departments of university hospitals and large to small teaching and non-teaching hospitals in the Federal Republic of Germany and West Berlin to gather information on the usage of antibiotics for the treatment of community-acquired pneumonia. A total of 288 (36%) questionnaires could be evaluated. In cases of non-life-threatening pneumonia, the therapy specified was mostly correct, although macrolides as the treatment of choice were stated only rarely (11%). However, patients with life-threatening pneumonia were most often (50%) treated with new beta-lactam antibiotics or beta-lactam antibiotics in combination with aminoglycosides (43%). Thus, atypical pathogens causing pneumonia were not covered by most therapeutic regimens.

Administration, Oral↗
PubMedDate not supplied

[Effect of Pseudomonas immunoglobulin on the antibacterial activity of human phagocytes].

The in vitro influence of a pseudomonas immunoglobulin in active and inactivated serum on the bactericidal activity and phagocytosis of human polymorphonuclear leukocytes was evaluated against Pseudomonas aeruginosa. No lysis of the bacteria could be found in either serum, however, the bactericidal activity of the leukocytes was significantly enhanced in active serum (p less than or equal to 0.05); whereas no effect was measurable in inactivated serum. Phagocytosis could be increased in concentrations of 10% immunoglobulin, (equivalent to 5 mg IgG/ml); however, a concentration of 15% showed a lower phagocytosis index which was comparable to that in the 5% preparation. This immunoglobulin proved to be able to support the bacterial phagocytosis and killing of P. aeruginosa by human polymorphonuclear leukocytes in vitro.

Humans↗
PubMedDate not supplied

Nosocomial and community-acquired infections in Germany. Summary of the results of the First National Prevalence Study (NIDEP)

The first German national study on the prevalence of nosocomial and community-acquired infections was performed in 1994 in medical, surgical, gynaecological/obstetrical and intensive care departments. 14,966 patients in 72 German hospitals representatively selected according to size were investigated by outside physicians. These were trained in the use of CDC definitions for nosocomial infections, and their diagnoses validated. Community-acquired infections were recorded according to the assessment of the hospital physicians. For the diagnosis of nosocomial infections, only the opinion of the outside investigators was decisive. A prevalence of 3.5% was found for nosocomial infections and 10.0% for community-acquired infections. The use of antibiotics was documented in 17.7% of all patients on the prevalence day. Of the patients undergoing antibiotic therapy, 16.9% had a nosocomial infection, 47.9% a community-acquired one. In the remaining 35.1% neither a nosocomial nor a community-acquired infection was confirmed.

Anti-Bacterial Agents↗
PubMedDate not supplied

Synergy of simultaneous administration of ofloxacin and granulocyte colony-stimulating factor in killing of Escherichia coli by human neutrophils.

The in vitro effect of subinhibitory and inhibitory concentrations of ofloxacin and G-CSF on the bactericidal activity of polymorphonuclear leucocytes (PMNL) against Escherichia coli was investigated. PMNL obtained from healthy volunteers were incubated with different concentrations of G-CSF and ofloxacin for 180 min. The minimum inhibitory concentration (MIC) of ofloxacin and even 1/4 x MIC enhanced the bactericidal activity of PMNL. G-CSF at a concentration of 6,000 units/ml led to a significant improvement of the bactericidal activity of PMNL. The combination of 6,000 units/ml of G-CSF and ofloxacin in inhibitory as well as subinhibitory concentrations, however, showed a significant synergistic effect on the antibacterial activity of PMNL during the complete incubation period. Combinations of G-CSF and antibiotics could therefore be beneficial for infected patients, especially those with impaired cellular host defense.

Adult↗
PubMedDate not supplied

Use of perioperative antibiotic prophylaxis in selected surgical procedures--results of a survey in 889 surgical departments in German hospitals.

In 1989, a survey on perioperative antibiotic prophylaxis was conducted in 2,739 surgical (general surgical, orthopedic, traumatologic, and cardiothoracic) departments of German hospitals. In all, 889 (32.5%) questionnaries were returned. Regarding the choice of antibiotic and the duration of prophylaxis the respective rates of correct statements were as follows: 32.6% and 55.0% in gastric surgery, 29.5% and 42.9% in colorectal surgery, 38.3% and 50.5% in biliary tract surgery, 81.0% and 41.0% in total hip replacement, 91.3% and 0% in heart valve replacement, and 95.7% and 0% in coronary artery bypass graft. Altogether, the choice of antibiotic and the duration of prophylaxis were correct in only 49.1% and 43.3%, respectively.

Anti-Bacterial Agents↗
PubMedDate not supplied

MIC and serum bactericidal activity of clindamycin against methicillin-resistant and -sensitive staphylococci.

Six volunteers were given 600 mg clindamycin intravenously to investigate the serum bactericidal activity (SBA) against 50 methicillin susceptible (MSSA) and 50 methicillin resistant Staphylococcus aureus (MRSA) strains. Minimal inhibitory concentrations (MIC) against MSSA, MRSA and 50 methicillin resistant strains of Staphylococcus epidermidis (MRSE), of which 50% were slime-producing, were determined. SBA of clindamycin against MSSA and MRSA was equally high (mean reciprocal SBA titer against MSSA vs MRSA 1 h after application was 13.0 vs 13.45), although MICs against MRSA were markedly higher than against MSSA (MIC 90 of MRSA vs MSSA: 0.06 vs > 32 mg/l). There was no difference in MICs between slime- and non-slime-producing MRSE.

Adult↗
PubMedDate not supplied

Shunt nephritis associated with Propionibacterium acnes.

Membranoproliferative glomerulonephritis was observed in a 22-year-old male patient in whom a ventriculoatrial shunt and a ventricular catheter were implanted after he was diagnosed in September 1989 with a cerebral cyst. Propionibacterium acnes infection of a central nervous system shunt was diagnosed. The ventriculoatrial shunt was removed (the catheter had become embedded in tissue and was left in place) and the patient was treated with cefotaxime (3 x 2 g) for 14 days. Renal function improved, but recovery was not complete.

Adult↗
PubMedDate not supplied

A randomized clinical trial of ceftriaxone and teicoplanin versus ceftazidime and teicoplanin as antibiotic therapy in febrile neutropenic cancer patients and bone marrow transplant recipients.

A prospective, randomized clinical trial comparing combination therapy with ceftriaxone and teicoplanin versus ceftazidime and teicoplanin in the treatment of febrile episodes in neutropenic cancer patients and bone marrow transplant recipients was performed. One hundred and two patients were randomized, but two patients were considered unevaluable for efficacy, and three patients were withdrawn due to incorrect randomization. Of the remaining 97 patients, infection resolved without modification of therapy in 31/49 (63%) patients treated with ceftriaxone/teicoplanin versus 27/48 (56%) patients treated with ceftazidime/teicoplanin (P = 0.48). Of all 97 patients treated therapy was modified in 18/49 (36%) with ceftriaxone/teicoplanin and 21/48 (43%) with ceftazidime/teicoplanin. Nineteen patients treated with ceftriaxone/teicoplanin received netilmicin and 21 patients treated with ceftazidime/teicoplanin also received netilmicin according to the study design (escalation therapy). When netilmicin was added infection resolved in 78% of patients treated with ceftriaxone/teicoplanin versus 84% of those treated with ceftazidime/teicoplanin. It was concluded that combination therapy with ceftriaxone/teicoplanin is an alternative to combination therapy with ceftazidime/teicoplanin, and has the advantage of once daily administration.

Adolescent↗