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J L Schmit

Publications and source records attributed to J L Schmit.

At least 37 records · Page 2Linked to original sources
PubMed1992

Efficacy of teicoplanin for enterococcal infections: 63 cases and review.

Sixty-three cases of monomicrobial enterococcal infections treated with teicoplanin in two open clinical studies in Europe from 1982 to 1989 are presented. Infections were documented as endocarditis (n = 18); septicemia (n = 8); and urinary tract (n = 29), skin/soft-tissue (n = 6), or bone/joint (n = 2) infections. A total of 63 enterococcal strains were isolated; all of 29 strains tested were susceptible to teicoplanin (geometric mean MIC, 0.16 micrograms/mL; range, 0.06-0.5 micrograms/mL). Forty-eight patients were treated with teicoplanin alone and 15 were treated with teicoplanin in combination with an aminoglycoside. The rate of clinical cure was 84.1%; 4.8% of patients clinically improved, 7.9% had clinical recurrence, and 3.2% did not respond to therapy. Bacteriologic eradication was observed in 87.2% of patients; persistence, in 3.2%; recurrence, in 3.2%; and reinfection, in 4.8%. One case was not evaluable bacteriologically. Of 18 patients with endocarditis, 15 were cured with a mean daily dose of 5.4 mg/kg--six with monotherapy and nine with combination therapy. All patients with urinary tract infections were treated with monotherapy, and 89.7% were cured (mean daily dose, 4.6 mg/kg). Lower rates of clinical cure and bacteriologic eradication were observed in septicemic patients without endocarditis (62.5%). This study demonstrated a good efficacy of teicoplanin for the treatment of enterococcal infections due to susceptible strains, but further clinical studies would be useful for establishing optimal dosage and the indications for combination therapy, especially for severe infections.

Adolescent↗
PubMed1991

Pharmacokinetics of single-dose intravenous, oral, and intraperitoneal pefloxacin in patients on chronic ambulatory peritoneal dialysis.

Comparison of plasma and dialysate concentrations of pefloxacin after intravenous, oral, or intraperitoneal administration shows excellent bidirectional diffusion of the quinolone through the peritoneal membrane, demonstrating that therapeutical concentrations can be achieved in the dialysate after intravenous or oral administration. In this study, the half-life of the drug was 18.8 +/- 1.4 h, i.e., apparently longer than that reported for normal controls or uremic patients on hemodialysis.

Administration, Oral↗
PubMed1990

[10 fatal endocarditis: autopsy observations, causes of death].

Among 841 autopsies realized between january 1982 and september 1988, by the Pathological the department of Amiens University Hospital the ten patients dead of infectious endocarditis have been autopsied. Macroscopic and microscopic observations have two cases of acute endocarditis and eight of subacute endocarditis. For the two patients dead of acute endocarditis, autopsy affirms the cardiovascular etiology of death. For the eight cases of subacute endocarditis, necropsic findings differs from the germs. In the three cases where the germ is a Staphylococcus aureus, the diagnosis of endocarditis was made before death and the cardiovascular etiology of death was affirmed by autopsy. For the other germs (3 Streptococcus sp, 1 Salmonella typhimurium, and 1 germ unknown), the diagnosis of endocarditis was made by autopsy, but necropsy disclosed the cause of death in only two cases.

Adult↗
PubMed1989

[Nosocomial infections caused by intravascular catheters].

In intensive care units nosocomial infections associated with intravascular catheters are an important cause of morbidity. Infection is essentially due to the implantation of cutaneous pathogens and to the contamination of infusion line components by manipulations. The risk of infection therefore mainly depends on the way the catheter is handled and on the duration of catheterization. The diagnosis of infection rests on clinical observation of the patient and on a semi-quantitative study of the catheter. Preventing such infections requires strict asepsis of the skin when the catheters is introduced and while it is maintained in situ and changes of infusions lines and of the catheter itself. These changes must be particularly frequent when the catheter is manipulated and when the patient is already infected prior to catheterization.

Asepsis↗
PubMed1989

[Infections caused by central venous catheterization at intensive care units].

All different types of catheters can induce localized (subcutaneous) or systemic sepsis. Infection rates of 7 to 20% have been reported in the literature; catheter infection results from bacterial colonization of the skin, colonization of the line or may be secondary to blood born seeding. In a one year prospective study of 56 catheters in our unit, the rate of systemic infection was 5.3%, insertion site infection 3.6%, and contamination without infection 25%. No catheter with less than 10(2) colonies on a semi-quantitative culture method was infected. Prevention of catheter related sepsis needs strict aseptic protocols, and short duration of catheterization, antiseptic wrapping of the line; antimicrobial filtersets may further reduce the infection risk.

Bacterial Infections↗
PubMed1987

[Treatment of post-traumatic and post-neurosurgical bacterial meningitis with ceftriaxone alone or in combination with fosfomycin].

From 1984 to 1986, 13 patients (10 adults, 3 children) with bacterial meningitis following neurosurgery or traumatism were given ceftriaxone alone 6 times at a dose of 40 mg/kg one IV injection per day, or in association 7 times with fosfomycin at a dose of 200 mg/kg/day, 3 IV perfusions every 4 h. The bacteriological diagnosis was confirmed in 9 cases (3 Staphylococcus aureus, 4 Streptococcus pneumoniae, 1 Klebsiella, 1 Peptococcus). In vitro neither synergy nor antagonism were observed between the two antimicrobial agents. The acute infections episode resolved in all patients except on who died with a negative CSF culture. One superinfection meningitis with Achromobacter was seen. CSF concentrations of ceftriaxone were assayed and found to be comparable with those reported by most authors. Tolerance was excellent for all our patients.

Adult↗
PubMed1986

[Hemorrhagic fever with renal syndrome. Apropos of 13 cases observed in Lorraine].

Thirteen cases of hemorrhagic fever with renal syndrome (HFRS) have been observed in the Nancy area. Ten occurred during the summer of 1983 and three in April and May 1985. The clinical characteristics were in each case very typical: abrupt onset with high fever, myalgia, intense lumbar and abdominal pain, pulsatile headache, inflammatory syndrome, WBC count increase and thrombocytopenia. Acute renal failure occurred a few days later with oliguria (9 cases out of 13), massive proteinuria (9/13) and hematuria (6/13). All patients recovered without sequelae within 8-10 days. Renal biopsy performed in 8 patients showed slight tubular lesions with interstitial mononuclear cell infiltrate, congestion and diffuse interstitial edema, and in 2 cases hemorrhagic extravasation. No glomerular lesions were observed. Clinical, histological and epidemiological characteristics of these 13 French cases are highly similar to those of the Scandinavian Nephropathia Epidemica reports. The epidemiology of HFRS remains unclear as do its pathophysiological mechanisms.

Adult↗
PubMed1986

[Clinical evaluation of timentin in intensive care].

16 patients admitted to a MICU were treated with timentin (ticarcillin + clavulanic acid) for bacterial infections: 11 cases of pulmonary infection, 3 cases of urinary tract infection, 2 septic shocks, 3 septicemias and 1 case of multifocal infection. The pathogens considered as a firmly established cause of infection were: 5 Acinetobacter, 12 Pseudomonas, 3 Serratia, 4 Klebsiella, 1 E. coli, 2 Proteus, 1 Providencia, 1 Staphylococcus aureus, 1 Staphylococcus epidermidis, 1 Streptococcus D and 1 Flavobacterium meningosepticum. The susceptibility of these pathogens to ticarcillin and timentin is reported. Timentin was prescribed alone in 9 cases and associated (with an aminoglycoside) in 7, in a daily dose of 9 to 18 g, for 6 to 45 days. 3 patients died. The value of timentin in infections due to multiresistant MICU pathogens is stressed.

Adult↗
PubMed1985

[Prophylactic antibiotic therapy using oxacillin in peripheral vascular surgery of the lower limbs. Preliminary results].

The rate of postoperative infections in lower limb vascular surgery was first evaluated in a retrospective study of 416 bypass procedures (68 venous grafts and 348 prosthetic grafts) in 400 patients seen over a two-year period. 31 postoperative infections (7.4%) were found. Outcome was fatal in three cases. 70% of cases were due to a methicillin-susceptible Staphylococcus aureus. Antibiotic prophylaxis with oxacillin given during surgery and for the first 48 postoperative hours was used for the next 112 procedures (17 venous grafts and 95 prosthetic grafts) in 107 patients. The preliminary results show a fall in the rate of postoperative infection, with only 5 cases (4.4%). The only case due to a methicillin-susceptible Staphylococcus occurred after a second surgical procedure without antibiotic prophylaxis. These preliminary results are promising although the difference does not reach statistical significance. However, it is of note that no patient undergoing vascular surgery for the first time developed postoperative infection. Further prospective studies are needed to determine the optimal antibiotic prophylaxis in lower limb vascular surgery.

Bacterial Infections↗