PubMed Health⌕ Search

Biomedical subjects

H Kafe

Publications and source records attributed to H Kafe.

14 recordsLinked to original sources
PubMed1986

Study of the diffusion of cefmenoxime into the bronchial secretions.

The wide spectrum of antibacterial activity of cefmenoxime as well as its resistance to beta-lactamase degradation, confers upon this drug a probable efficacy in the treatment of common respiratory infections. The objective of this study was to evaluate the penetration of cefmenoxime into bronchial secretions taken in patients, mostly with chronically superinfected bronchial pathology. Bronchial samples were collected by means of fiber-optic bronchoscopy; simultaneous serum samples were also taken after bolus intravenous injection of 1 g of cefmenoxime, after a single dose in 12 patients (group I); after multiple doses in 12 patients (group II). Concentrations of cefmenoxime were determined by means of microbiological procedure. The results showed: bronchial kinetics of cefmenoxime similar to those of other cephalosporins studied previously; after multiple doses a bronchial steady state with a slow decrease of bronchial levels as a function of time; no difference between levels measured after single or multiple doses; a ratio between bronchial levels (B) and simultaneous serum (S) levels (B/S, %) of about 10% at the 2nd hour, 20% at the 4th hour. Due to the extremely low MICs for most bacteria responsible for respiratory infections, cefmenoxime might be expected as the drug of choice in the treatment of bronchopulmonary infections.

Bacterial Infections↗
PubMed1986

[Diffusion of piperacillin into bronchial secretions].

Piperacillin is a ureido-penicillin characterized by the presence of a piperazine group at the position 6 of the beta-lactam ring. This group confers a broader spectrum that includes Pseudomonas. In vitro studies have shown that piperacillin is active against clinical strains recovered from intensive care unit patients with severe lower respiratory tract infections. The purpose of our study was to investigate the usefulness of piperacillin in such patients by evaluating the drug's diffusion into bronchial secretions. A single 4 g dose of piperacillin was given intravenously over three minutes to each of 6 intensive care unit patients. Serum and bronchial secretion samples (obtained through a tracheal intubation or tracheostomy tube) were taken 1/2 hour, 2 h, 4 h and 6 h after the injection to evaluate piperacillin kinetics. Serum piperacillin concentrations were maximal 30 mn after the IV (mean value: 90.6 +/- 23.8 micrograms/ml) and thereafter fell gradually (mean value after 4 hours: 40.4 +/- 27.5 micrograms/ml). Peak concentrations in bronchial secretions were recorded at 2 hours (12.2 +/- 8.5 micrograms/ml); the mean residual value at 6 hours was 4.9 +/- 8.7 micrograms/ml. The diffusion ratio (ratio of bronchial secretion concentration to simultaneous serum concentration) was 15.5% to 24.5%. Our results show that the diffusion of piperacillin into bronchial secretions is outstanding and support the use of this drug in severe respiratory tract infections.

Adult↗
PubMed1985

The penetration of macrolides into bronchial secretions.

Macrolides have shown efficacy in the treatment of a large range of respiratory infections. These antibiotics are well tolerated, have a narrow antibacterial spectrum, and excellent diffusion properties. We have studied the penetration into bronchial secretions of three macrolides, erythromycin, josamycin and oleandomycin. The bronchial concentrations of erythromycin reached an average of 1 mg/l 2 h after oral administration of 1 g; they were lower for josamycin (0.52 mg/l) but the ratio between bronchial and simultaneous serum concentrations was similar for both drugs. Bronchial levels of oleandomycin were rapidly higher than the serum levels, reaching 3 to 4 mg/l, a ratio of more than 100%. Other studies on tissue concentrations of erythromycin and josamycin showed local levels of 4 to 6 mg/l, whereas in bronchial secretions the concentrations were identical to those measured in our study. On the whole, the good diffusion of macrolides into respiratory tissues and secretions as well as in-vitro antibacterial activity against most species responsible for respiratory infections confirm their indication in the treatment of these infections.

Adult↗
PubMed1984

Penetration of cefsulodin into bronchial secretions.

The objective of this study was to evaluate the penetration of cefsulodin, a new cephalosporin active against Pseudomonas aeruginosa, into the bronchial secretions. The study was carried out in 28 patients with respiratory infections; 11 patients received a single dose of 1 g i.v. (bolus); 17 patients received multiple doses of 1 g every 8 h for 48 h. Simultaneous samples of blood and bronchial secretions were collected 30 min and 1, 2, 4 and 6 h after injection. Bronchial secretions were obtained from 23 patients by means of fiberoptic bronchoscopy and in 5 tracheostomized patients (with severe respiratory insufficiency) through a tracheostomy cannula. The assays of cefsulodin were performed by means of the microbiological agar diffusion technique. The results of the study showed a noticeable penetration of the drug into the bronchial secretions, with a mean peak reaching 3.1-5.3 micrograms/ml at the 3rd or 4th hour, a slow elimination and residual levels at 6 h ranging between 2.0 and 6.0 micrograms/ml. The rate of penetration was not influenced by the administration of multiple doses of the drug. The ratios between bronchial concentrations and simultaneous serum concentrations ranged between 10 and 30%, corresponding to the usual values found for other cephalosporins. In conclusion, this study provides satisfactory results and confirms the presence of bronchial levels capable of inhibiting P. aeruginosa.

Bronchi↗
PubMed1984

[Bronchial diffusion of new anti-pseudomonal beta-lactams. Clinical significance].

In treating severe respiratory infections due to Pseudomonas aeruginosa and in patients with cystic fibrosis, new anti-pseudomonal beta-lactams constitute a good alternative to the traditional aminoglycoside antibiotic therapy. Among several criteria for the choice of an antibiotic, estimation of intrabronchial levels is to be taken into account. The authors report the results of the study of a new semi-synthetic penicillin, apalcillin, and two cephalosporins (cefsulodin, ceftazidime), active in vitro against Pseudomonas; their penetration into respiratory secretions was evaluated in 48 patients, intubated, tracheostomized, or undergoing fiberoptic bronchoscopy. Antibiotic concentrations were measured by the microbiological procedure. Bronchial penetration of apalcillin was early and noticeable, reaching a bronchial peak representing 20% of the simultaneous seric concentration. The local levels of cefsulodin and of ceftazidime did not differ from those achieved with cephalosporins studied previously; the bronchial peak reached 5,6 micrograms/ml for both drugs 2 hours after administration; this bronchial level corresponded to 15 to 20% of the serum concentration. The clinical response could not be evaluated due to the severe underlying pathology which compromised the outcome of the disease in the patients of this study. However, at least for apalcillin, a significant correlation was noted between bronchial levels, susceptibility of bacteria isolated in patients, and eradication of susceptible organisms.

Anti-Bacterial Agents↗
PubMed1983

[penetration of fosfomycin into bronchial secretions].

The objective of this study was to evaluate the penetration of fosfomycin in bronchial secretions in 11 tracheostomized patients which allowed sampling at successive times, following intravenous injection of 4 gr of the drug during 4 hours. In simultaneous samples of serum and bronchial secretions, the measurement of fosfomycin was performed according to the agar diffusion microbiological method. The results of the study showed a worthwhile penetration of fosfomycin, with a mean bronchial concentration reaching 13,1 micrograms/ml, half an hour after the end of the injection, decreasing slowly with 7,04 micrograms/ml remaining two hours after the injection. The ratio between bronchial levels and corresponding serum levels reached 13% two hours after the injection. Fosfomycin diffusion from serum to bronchial secretions realizes significant amounts that are superior to the MICs of fosfomycin for most bacteria responsible for serious broncho-pulmonary infections in intensive care units.

Anti-Bacterial Agents↗
PubMed1982

Study of the diffusion of cefotiam in the bronchial secretions.

The objective of this study was to evaluate the concentration in the bronchial secretions of a new injectable cephalosporin, cefotiam, which is characterized by an excellent antibacterial activity, stability against beta-lactamases and interesting pharmacokinetic properties. 30 patients suffering from acute exacerbation of a chronic bronchitis or bronchiectasis with expectoration, received either 1 g i. v. of cefotiam in a single dose or four doses of 1 g each over a period of 3 days. The bronchial secretion samples were obtained by fibroscopy, 1, 2, or 4 h after the last dose, in order to evaluate the kinetics of the bronchial concentration of cefotiam. Blood samples were taken simultaneously in order to establish a possible correlation between the bronchial and serum levels of the drug. The results of the study show a rapid and significant transfer of the drug through the bronchoalveolar capillaries, elevated bronchial concentrations starting from the 2nd h, reaching 10 micrograms/ml (or more) in certain cases, slow elimination with bronchial concentrations persisting at high levels for up to 4 h and a ratio between bronchial and serum concentrations of 25-60% at the 2nd h and more than 100% at the 3rd and 4th h. These results confirm the excellent diffusion of cefotiam, especially in the respiratory tract, allowing bronchial levels largely superior to the minimum inhibitory concentrations required to kill the bacteria usually responsible for lower respiratory tract infections.

Anti-Bacterial Agents↗
PubMed1979

Penetration of ampicillin into human bronchial secretions.

Ampicillin concentrations in serum and bronchial secretions after oral administration of bacampicillin were evaluated. Twenty-eight hospitalized patients with acute bronchopulmonary infections received a single dose of 800 mg of bacampicillin. Samples of bronchial secretions were obtained during diagnostic bronchoscopy and blood samples were drawn simultaneously. Significant concentrations of ampicillin were found in bronchial secretions, the peak level, reached after approximately two hours, being 0.27 micrograms/ml on an average. The penetration of ampicillin into the bronchial secretions after the administration of bacampicillin could be correlated with the degree of bronchial inflammation, as illustrated either by macroscopic purulence or protein concentration in the secretions. The results suggest that bacampicillin is a useful drug in acute bronchopulmonary infections.

Administration, Oral↗
PubMed1978

[Pharmacokinetic study of antibiotics in human respiratory tract (author's transl)].

We report the results of the study of the bronchial concentrations of several antibiotics. The experiment included 280 patients and the concentrations achieved in bronchial secretions were measured for 11 antibiotics. The samples of bronchial secretions were taken in situ by fibroscopy or through the tracheostomy cannula. The results of the study show that the rate of penetration is variable according to the different drugs; even in the same antibiotic family such as beta-lactam antibiotics the rate of penetration is variable. The bronchial levels of aminoglycosides, macrolides and tetracyclines are worthwhile, and are often superior to the MIC of the infecting organisms; the penetration is also dependant of the inflammatory conditions of the bronchi. Otherwise the sampling conditions were the best possible since samples taken by fibroscopy or by tracheostomy are not contaminated by saliva which is a factor of dilutional error. The methodology used in this study is an approach of pharmacokinetics of antibiotics in respiratory tract.

Adult↗
PubMed1978

Pharmacokinetic study of beta-lactam antibiotics in bronchial secretions.

The objective of the study was to evaluate the concentrations obtained in serum and bronchial secretions after administration of five beta-lactam antibiotics: cephradin (1 g per os) and cefoxitin (2 g i.v. infusion), amoxycillin (1.0 g per os), bacampicillin (0.4 g and 0.8 g per os) and ampicillin (1.0 g per os). 123 adult patients were included in the study and received a single dose of the tested drug. Serum and mucus samples were collected simultaneously 30 minutes, 1, 2 or 4 hours after administration of the drugs. Mucus samples were taken by fibroscopy but in some patients the samples were collected through a tracheostomy cannula which allowed sampling at different time intervals. The results show that the concentrations of penicillins in bronchial secretions increase progressively between one and four hours after administration of the drugs. Bronchial levels obtained after oral administration of ampicillin are low, not more than 5 to 10% of serum levels. The other antibiotics tested show worthwhile concentrations in bronchial secretions, especially with cephalosporins and bacampicillin which exhibits higher serum and bronchial concentrations than ampicillin.

Amoxicillin↗