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Biomedical subjects

H Langmaack

Publications and source records attributed to H Langmaack.

At least 37 records · Page 2Linked to original sources

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↗

Surveillance, prevention and control of hospital-acquired infections. III. Nosocomial infections as cause of death: retrospective analysis of 1000 autopsy reports.

One thousand post-mortem reports were analysed retrospectively to see whether the patient had had a nosocomial or community-acquired infection and whether this led directly to or contributed to the patient's death. In 7.4% of all autopsies nosocomial infection was the direct cause of death. In 6.3% of the patients, nosocomial infection was a contributory factor leading to death. The most common hospital infections were pneumonia, septicaemia, peritonitis, meningitis, and hepatitis B. Most infections which led to or contributed to death were acquired in surgical wards. Patients with nosocomial infections, however, were more endangered by factors predisposing to infections (1.8 factors per patient) than patients without nosocomial infections (0.67 factors per patient). Sixty-three patients acquired an infection outside the hospital; in 70% of these patients, the infection was the main or contributory cause of death.

Adolescent↗

[Bacterial endocarditis. Clinical picture, treatment and course in 37 patients (author's transl)].

Between March 1971 and April 1976 37 patients were seen with manifest bacterial endocarditis. The main signs were high temperature and cardiac murmurs whereas other "classical" signs such as splenomegaly, anaemia, leucocytosis, and positive anti-streptolysin titres were much less frequent. In 35 cases bacteriological proof was possible. As causative organism a total of 30 gram-positive organisms (of which 15 were Streptococcus viridans and 8 were Staphylococcus species) and 10 gram-negative bacteria (4 of which were Pseudomonas aeruginosa) could be demonstrated. Treatment was mainly with beta-lactam and/or aminoglycoside antibiotics. Use of the combination of penicillin and streptomycin or gentamicin was based on the results of in-vitro bactericidal activity. The main complications were emboli, penicillin allergies, pulmonary involvement and cardiac complications. 13 patients died; the main cause was cardiac failure which was irreversible even despite operative valve replacement during the acute infection in two cases.

Adult↗

[Azlocillin and mezlocillin: two new semisynthetic acylureido-penicillins (author's transl)].

The pharmacokinetic parameters of two new ureido-penicillins (azlocillin and mezlocillin) were determined in 12 healthy subjects after a half-hour continuous infusion of 5,000 mg. The agar diffusion test (test strain Bacillus subtilis ATCC 6633) was used for the microbiological assays. The mean azlocillin serum concentration after the half-hour infusion was 431.0 +/- 75.0 microgram/ml; after eight hours it had fallen to a mean value of 4.7 +/- 2.6 microngram/ml. The mean elimination half-life was 77.5 +/- 10.4 minutes, and the relative distribution volume was 19.4 +/- 1.9% of the bodyweight. At the end of the infusion, mezlocillin showed a mean serum concentration of 426.0 +/- 61.0 microgram/ml and after eight hours an average of 1.1 +/-0.9 microgram/ml; the half-life was shorter (56.9 +/- 9.9 minutes) and the distribution volume lower (14.8 +/- 3.1%) than that of azlocillin. The renal clearance values measured in three subjects during a four-hour continuous infusion were: azlocillin 111.6 ml/min/1.73 m2, mezlocillin 121.5 ml/min/1.73 m2. The kinetic behaviour of the two ureido-penicillins was essentially very similar to that of ampicillin and carbenicillin, 38 patients with bronchopneumonia, cholangitis or urinary tract infections, which in some instances were severe, were treated for an average of 10 days with an average daily dosage of 3X4.0 g azlocillin or 3X5.0 g mezlocillin. 30 patients showed clinical improvement, and in 17 of these the pathogen was eliminated. These therapeutic results appear more favourable than those obtained with the newer aminoglycoside antibiotics (amikacin, sisomicin); in particular the drug was well tolerated.

Adult↗

[Ways to an efficient and practicable hospital hygiene from the point of view of a hospital hygienist (author's transl)].

Hospitalepidemiology means surveillance, prevention andocntrol of nosocomial infections. Trying to succeed he has to search for possiblities which are both practical as well as efficient: 1. The infection control nurse (one for 300 beds), 2. a bacteriological labor is for the epidemiologist, which is able to perform routine control on certain areas in the hospital (kitchen, sterilisation etc.), 3. encironmental examinations if necessary to find sources and for teaching purposes, 4. training of hospital personal in prevention, recognizing nosocomial infections, performing methods of desinfections etc., 5. trying to cooperate with the clinician in chemotherapy (selection of antibiotics, prophylaxis etc.), 6. to develop a programm to collect datas about nosocomial infections by a computer and to analyse those datas afterwards, 7. collaborativ work in a infection control commitee.

Anti-Bacterial Agents↗

[Pharmacokinetics and clinical experience with amikacin. A new aminoglycoside antibiotic].

The pharmacokinetic data of amikacin were determined after a 1 hr constant infusion with a dosage of 7.5 mg/kg body weight in 12 healthy test subjects. Microbiological bioassay was performed by the agar diffusion test. After the infusion, the mean amikacin serum concentration was 37.5 mug/ml and, 8 hours later, decreased to an average of 1.3 mug/ml. The biological half-life amounted to a mean of 114.2 min, the area below the concentration-time-curve was calculated to an average of 140.4 hr - mug/ml. The renal clearance of amikacin was determined during a 4 hr constant infusion in 3 test individuals; the average clearance was 84.3 ml/min - 1.73 m2. 38 patients with severe bronchopulmonary, urinary and peritoneal infections were treated with an average daily dose of 10-15 mg of amikacin per kg body weight during a mean period of 10 days. 32 patients showed clinical improvement, 17 of them with complete elimination of the pathogenic bacteria.

Adult↗

Pharmacokinetic and clinical studies with amikacin, a new aminoglycoside antibiotic.

Pharmacokinetic parameters of amikacin were determined in 12 healthy volunteers after a 1-hr continuous intravenous infusion of 7.5 mg of the drug/kg. The serum concentration rose rapidly to a peak of 37.5 +/- 4.9 mug/ml at the termination of the infusion and declined to 1.3 +/- 0.5 mug/ml 8 hr later. The mean half-life was 114 +/- 16.7 min, and the apparent volume of distribution was 18.1% +/- 1.8% of body weight. During a 4-hr constant intravenous infusion in three subjects, amikacin was cleared from the kidney at a mean rate of 84.3 ml/min per 1.73 m2, and from the serum at a mean rate of 129.7 ml/min per 1.73 m2. Of the administered dose, 93.5% was recovered from the urine in 24 hr (81.7% during the first 6 hr). After single intramuscular injections of 5 mg/kg in 30 patients, serum levels peaked at 1 hr (21.4 +/- 5.4 mug/ml) and declined to 2.4 +/- 0.9 mug/ml by 8 hr. Of 33 patients with serious urinary or bronchopulmonary infections (usually superimposed on chronic organic pathology) treated with amikacin (10 or 15 mg/kg per day for eight to 17 days), 27 had a clinical remission, and in 15 of these patients the pathogen was eradicated.

Adult↗

[Cultivation possibility for obligatory anaerobic bacteria from contaminated cotton carriers after storage. Comparative testing of simple swabs and swabs in transport medium using Stuart's method].

26 strains of obligate anaerobic bacteria, which had been isolated from clinical specimens, were tested for their survival on artificially contaminated cotton swabs after storage. All strains could hardly if at all be cultivated, if the cotton swabs had been stored in empty test tubes at 4 degrees C for 48 hrs. In contrast to that it was possible to cultivate all strains without significant reduction of their number from swabs, which were stored at 4 degrees C for 48 hrs in test tubes containing Stuart's transport medium. The necessity of an improvement of techniques and transport-methods to isolate anaerobic bacteria is discussed. The use of a special transport medium is recommended as an important aid to the early recognition of anaerobic infection.

Anaerobiosis↗

[Pharmacokinetics and clinical observations of sisomicin, a newly developed aminoglycoside derivative (author's transl)].

In a randomized study of 12 healthy subjects the pharmacokinetics of gentamicin, sisomicin and tobramycin were determined after a one-hour infusion of each drug (1.0 mg/kg body-weight) four weeks apart. There were no pharmacokinetic differences of therapeutic significance between the three drugs. The mean serum concentrations at the end of infusion were 3.85 mug/ml for gentamicin and 4.66 mug/ml for sisomicin, falling to 0.12 and 0.26 mug/ml, respectively, after eight hours. The biological half-life varied between 96 and 122 min and the apparent volumes of distribution corresponded closely tothe size of the extracellular space. The antibacterial effectiveness, tolerance and modes of application were studied in 24 patients, most of them with urinary infection, at a dosage of 1.0 mg per kg body-weight two to three times daily. Good clinical results were achieved in 15, satisfactory ones in three, and in 16 the causative bacteria were eradicated. Sisomicin was well tolerated, except for minor and reversible renal (2 patients), hepatic (3 patients), and hearing (1 patient) disturbances.

Adult↗