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Biomedical subjects

M Hejzlar

Publications and source records attributed to M Hejzlar.

At least 19 recordsLinked to original sources
PubMed2000

Changes of the serum antibiotic levels during open heart surgery (ceftazidim, ciprofloxacin, clindamycin).

BACKGROUND: Wound, mediastinal and intracardiac infections are still very serious complications of open-heart surgery. The incidence of it is still in the range of 0.4%-5%. The aims of our study were to assess the adequacy of regimen using ceftazidim (CTZ), ciprofloxacin (CPF) and clindamycin (CLIN) as prophylactic antibiotics and to verify whether cardiopulmonary bypass (CPB) can modify the time of antibiotic serum concentrations. That is why the serum levels of them were measured during open heart procedures. METHODS: The prospective study comprised 75 consequent coronary patients randomized in to three groups receiving 1 g of CTZ or 400 mg of CPF or 900 mg of CLIN i.v. with anesthesia induction. Routine coronary surgery with left internal mammary artery harvesting, moderate body hypothermic (30 degrees C) CPB with crystaloid cardioplegia was performed. Serum antibiotic levels were determined before application, with skin incision, prior CPB induction, after cardioplegia infusion, every 20 minutes of CPB, prior end of CPB, in time of chest closure. Conventional cylinder-plate microbiological assay was used for antibiotic level measurement. RESULTS: All serum antibiotic concentrations showed a sharp decrease immediately after starting CPB and lasted until CPB ended. After initiating of CPB after cardioplegia administration serum concentrations of CTZ (105 min after initial dose) decreased by, on average 55%, CPF (97 min) by 42% and CLIN (116 min) by 78%. CONCLUSION: CPB can modify the time course of antibiotic serum concentrations. The serum levels of CTZ at the end of the longest procedures were found to be below the MICs for some of the suspected pathogens. We recommend to use higher antibiotic doses for prophylaxis and to administer the second dose with protamin sulphate to obtain maximum concentration in newly formed blood clots.

Anti-Bacterial Agents↗
PubMed1999

[Kinetics of ceftazidime in prophylactic administration during cardiopulmonary bypass].

Serum ceftazidime levels were followed in 21 patients in which routine coronary bypass surgery with cardiopulmonary bypass was performed. Each patient received one gram of ceftazidime intravenously with anesthesia induction. Antibiotic concentrations were estimated using the microbiologic assay diffusion plate method. The average operation time was 220 +/- 41 minutes (range 130-310). The start of cardiopulmonary bypass was 86 +/- 21 minutes and the full flow time was 104 +/- 21 minutes after starting of ceftazidime application. It can be stated that the decline of ceftazidime serum levels after starting of cardiopulmonary bypass was faster in comparison with standard serum curves of this antibiotic. The concentrations of ceftazidime at the end of some operations were under the supposed minimal inhibitory concentrations for some microorganisms possibly implicated. No infection was recorded.

Cardiopulmonary Bypass↗
PubMed1990

The effect of antibiotics on the function of the phagocytic system.

The present paper reviews the effect of various antibiotics (ATB) on the cells of the phagocytic system. The first part deals with an indirect mechanism of action of ATB, i.e. with changes induced in the bacterial cell which in turn renders these bacteria susceptible to phagocytosis. In the second part, the direct effect of ATB on phagocytic cells is discussed: binding of ATB to phagocytes, penetration into the cell, change in chemotactic (migratory) activity, effects on ingestion of particles, intracellular killing of bacteria and on phagocytosis-associated metabolic changes (e.g. chemiluminescence).

Anti-Bacterial Agents↗
PubMed1990

[Cefuroxime axetil (Zinnat)--laboratory and clinical study].

The authors investigated the antibacterial action of cefuroxim in vitro and proved its relatively broad spectrum of action. Administration of the esterified form, Zinnat, produced very satisfactory therapeutic concentrations of cefuroxim in serum, bile tissue of operated gallbladders. The prophylactic administration of the combined parenteral and oral form of cefuroxim proved excellent in biliary surgery in twenty patients.

Adult↗
PubMed1989

Roxithromycin--a new macrolide derivative.

This ether oxim derivative of erythromycin A is an easy to absorb oral antimicrobial somewhat less effective in vitro than erythromycin. At relatively low MIC's it is active against staphylococci, streptococci, pneumococci, branhnamella and chlamydiae, higher concentrations are needed against enterococci and some strains of H. influenzae. Roxithromycin is also reported to have a very good effect on campylobacters, many anaerobic bacteria, Toxoplasma gondii, Treponema pallidum, Mycoplasma pneumoniae and Legionella pneumophilla. Its half-life in the serum of healthy individuals ranges from 9 to 16 hours. Maximum serum concentrations at 2 oral doses of 150 mg a day are reached at 3 to 4 days and vary from 5.5 to 11.1 mg/l. The distribution of roxithromycin in body tissues is excellent. In a group of 57 patients treated for various infections of clear etiology the positive therapeutic effects resulting in the state of bacteriological negativity was reached in 86% of cases. Roxithromycin can be recommended as a drug of choice in mild or less severe cases of infection caused by agents sensitive to this antimicrobial. Its excellent tolerance makes it especially well suited for use in pediatric practice.

Adult↗
PubMed1984

Antimicrobial profile of ceftazidime: the situation in three larger hospitals in Prague between 1981 and 1983.

As a part of preclinical trials of 2,996 clinical isolates from three larger hospitals in Prague were qualitatively and quantitatively assayed for in vitro sensitivity to ceftazidime. In gramnegative bacteria the incidence of resistance to ceftazidime in strain of Enterobacter, Serratia Proteus and Pseudomonas species ranged from 4% to 6% of strains. In grampositive bacteria only strains of enterococci, listeriae and anaerobic bacteria are excluded from the action of this broad-spectrum antibiotic. According to present experiences the antipseudomonal activity of ceftazidime is approximately the same as that of cefsulodine and cefoperazone. Alarmingly, one of the Pseudomonas aeruginosa isolates was found to show a distinct multiresistance to all available lactam, aminoglycoside and broad-spectrum antimicrobials, including ceftazidime.

Bacteria↗