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O Brückner

Publications and source records attributed to O Brückner.

At least 19 recordsLinked to original sources

[Infection caused by gram-positive and gram-negative bacteria. A comparative study].

The clinical symptomatology of bacterial septicemias was analysed in 417 patients of a University Hospital in West Berlin. Sepsis was caused by Gram-negative organisms in 229 cases, and by Gram-positive bacteria in 177 cases; 11 cases presented with a mixed type sepsis involving both Gram-positive and Gram-negative pathogens. With the exception of a drop in blood pressure, observed appreciably more often in Gram-negative infections (42.4% of the cases as compared with only 25.4% in the case of septicemia due to Gram-positive organisms, (p less than 0.01), no significant clinical differences were seen between Gram-negative and Gram-positive sepsis. Pathophysiological changes (thrombopenia, leukopenia, coagulopathies) that are considered classical reactions to endotoxin, were also observed in Gram-positive infections. The overall prognosis of septicemia was determined largely by the severity of the underlying pathological condition.

Bacterial Infections

Comparative efficacy of ciprofloxacin, ceftazidime and gentamicin, given alone or in combination, in a model of experimental septicemia due to Klebsiella pneumoniae in neutropenic mice.

The therapeutic efficacy of ciprofloxacin, used alone and in combination with either ceftazidime or gentamicin, was evaluated in a model of experimental Klebsiella pneumoniae septicemia in neutropenic mice. Therapeutic results were compared to those achieved by treatment with ceftazidime or gentamicin alone, as well as their combination. Infections were induced by i.v. injection of two strains of K. pneumoniae. Therapy with i.m. antibiotics was performed in 8 h intervals for a total of 13 doses, and survival rates were recorded at the end of treatment as well as seven days later. Ciprofloxacin alone proved to be significantly more effective than ceftazidime and gentamicin, producing survival rates similar to the combination of ceftazidime plus gentamicin. Bacterial counts of spleens and blood confirmed the superior bactericidal activity of ciprofloxacin. Except for the combination of ciprofloxacin with ceftazidime, there was no apparent advantage of combinations of ciprofloxacin with the other agents compared to ciprofloxacin alone. These data suggest a high in vivo activity of ciprofloxacin in systemic infection due to K. pneumoniae.

Agranulocytosis

[Rational parameters in the treatment of bacterial meningitis with modern cephalosporins].

Modern cephalosporins are by now well established therapeutic drugs in the treatment of bacterial meningitis. Particularly for gram-negative meningitis they are valuable therapeutic tools. In most cases, they are very efficient and less toxic than former therapeutic regimens. Of course, they cannot replace penicillin G in the therapy of meningitis with penicillin-sensitive bacteria. The advantages and disadvantages of the single compounds, cefotaxime, latamoxef, ceftizoxime, cefmenoxime, ceftazidime, ceftriaxone and cefsulodin have to be evaluated. For safety reasons, monotherapy with these drugs is not recommended because there have been reports of failures and relapses of meningitis even in cases with highly sensitive organisms. They are almost or completely ineffective against a few pathogens in meningitis, such as anaerobes or Listeria monocytogenes. An attempt has been made to evaluate the different compounds for their therapeutic usefulness against different pathogens in meningitis.

Adolescent

Comparative efficacy of different beta-lactam antibiotics and gentamicin in Klebsiella pneumoniae septicaemia in neutropenic mice.

The in-vivo activity of ceftazidime, cefotetan, imipenem/cilastatin, piperacillin and gentamicin against two strains of Klebsiella pneumoniae was evaluated in a model of experimental septicaemia in neuropenic mice. Single agent therapy with the aminoglycoside was highly effective against both strains. Among the beta-lactams, ceftazidime and cefotetan were nearly as active as gentamicin, whereas imipenem/cilastatin was slightly less effective, and the results achieved with piperacillin were markedly inferior.

Animals

[Current aspects of pseudomonas meningitis].

The article reports on the incidence, the conditions of occurrence, possibilities and successes of treatment with certain (combinations of) antibiotics, in dealing with cases of pseudomonas meningitis. The various possible substances used for treatment are discussed. Rates of penetration and CSF concentrations of azlocillin and cefsulodin are stated. Alternative possibilities for treatment are pointed out.

Aminoglycosides

A study of the penetration of temocillin in the cerebrospinal fluid.

Temocillin concentrations in serum and cerebrospinal fluid (CSF) samples from 8 patients were assayed by high pressure liquid chromatography. It was possible to determine sequential series of ventricular (CSF) and serum concentrations in 4 adult neurosurgical patients with slight to moderate impairment of blood-CSF barriers, because serial CSF samples were obtained from external ventricular drains. In 4 other patients with meningitis, temocillin was given in addition to the regular treatment schedule and 6 'spot' concentrations of temocillin in lumbar CSF and serum samples were determined. Temocillin CSF concentrations in these subjects seemed to be inadequate for the treatment of Gram-positive bacterial meningitis and only partially valuable for the treatment of Gram-negative bacillary meningitis.

Adult

[Anaerobic bacterial meningitis with multiple brain abscesses].

The improvement of bacteriological techniques for isolation and identification of anaerobes has led to an increased interest in anaerobic infections. However, anaerobes have only rarely been found in cases of purulent meningitis, representing less than 1 percent of all isolated pathogens. We observed anaerobic meningitis in a patient suffering from multiple lung abscesses from which anaerobic bacteria spread to the brain, causing formation of anaerobic brain abscesses and consecutive meningitis. Microbiological examinations for anaerobes should be performed in those cases of meningitis in which purulent infections of other organs with known or suspected anaerobic etiology are present or in which a traumatic lesion of the subarachnoid space has preceded the development of meningitis.

Adult

[Diagnosis and antibiotic treatment of infectious diseases in general practice. Results of an inquiry].

In February 1982 a questionnaire was sent to 2138 doctors in general practice in West Berlin, to obtain data relating to the incidence and treatment of infectious diseases. Replies were received from 453 (21%). Regular bacteriological tests were undertaken only for urinary tract infections, by 60% of those replying. The 453 doctors reported a total of 9280 cases of infectious disease during a one-week period, 6094 respiratory and 1723 urinary ones. Antibiotic prescriptions numbered 6118 during this period, 56.7% for respiratory and 27% for urinary tract infections. Indications for antibiotic treatment were predominantly decided on clinical grounds.

Anti-Bacterial Agents

Netilmicin in human CSF after parenteral administration in patients with slightly and severely impaired blood CSF barrier.

After administration of 150 mg netilmicin samples of CSF and blood were obtained. In one group of nine patients with no or only slight impairment of the blood-CSF-barrier 29 samples of CSF were assayed for netilmicin concentrations. All samples, obtained after the first dose, failed to reveal detectable drug levels. Drug levels up to 0.18 mg/l were detected in samples of CSF of three patients after 3 to 22 doses. Only the lumbar CSF of one patient contained netilmicin concentrations higher than 1.0 mg/l. In comparison 19 samples of CSF, obtained from patients with meningitis after more than one dose of netilmicin, had levels of 0.27-5.0 mg/l. Three CSF samples from patients out of this group, collected after the first dose of netilmicin failed to show any drug activity.

Adult

Focal tuberculous meningoencephalitis.

Tuberculous meningitis was diagnosed in a 16-year-old patient with symptoms and signs of a space-occupying process of the right hemisphere. Cranial computed tomography demonstrated focal encephalitis of the right temporoparietal region. The case reminds that tuberculous meningitis can present itself under uncommon neurologic syndromes and should, even in the presence of such unusual findings, be considered with a high index of suspicion.

Adolescent

Cefotaxime levels in ventricular cerebrospinal fluid, determined by bioassay and by high-performance liquid chromatography.

Five series of cerebrospinal fluid (CSF) samples, obtained from external ventricular drains (EVD) of 4 neurosurgical patients with cefotaxime treatment were tested simultaneously by high-performance liquid chromatography (HPLC) and microbioassay using E. coli V 6311/65 as test organism. Higher cefotaxime (CTX) concentrations in CSF were measured by the microbioassay method in 4 of the 5 series, reflecting the microbioassay being influenced by increasing amounts of desacetyl-cefotaxime (DAC) during the post-application interval. Decrease of CTX levels in CSF was consistently faster in tests performed by HPLC than those using microbioassay. The clinical efficacy in gram-negative bacillary meningitis is to be explained by levels of the parent compound CTX in CSF which are several times higher than the minimal inhibitory concentrations (MICs) of most enterobacteriaceae.

Adolescent

[Toxic shock syndrome].

The entity of the variable pictures of an illness summed up by the description "toxic shock syndrome" has been focussed on by a great number of publications in Northern America since 1978, but has been described scarcely until yet in Germany. An etiological relationship with formerly described "toxic scarlet fever" and "Kawasaki syndrome" is to be discussed. This case in charge deals with a 25-year-old female patient, who developed acutely without any former disease during her menstruation an illness of severe clinical presentation. The findings were high fever, arterial hypotension, and reversible renal failure, watery diarrhea and vomitus , different cutaneous manifestations and signs of disseminated intravascular coagulation, and severe thrombocytopenia with bleeding mucosal ulcerations. Massive growth of Staphylococcus aureus was demonstrable as well as growth of Proteus mirabilis and E. coli in a culture of vaginal smear.

Adult

Cefotaxime in treatment of meningitis and ventriculitis? Evaluation of drug concentrations in human cerebrospinal fluid.

In three groups of patients levels of cefotaxime in serumand cerebrospinal fluid were determined. Therapeutic value and efficacy are discussed in meningitis patients. Nine concentrations of cefotaxime in lumbar and ventricular CSF out of 19 in a group of seven neurosurgical patients with mild to moderate impairment of the blood-CSF-barrier were higher than 0.5 micrograms/ml. In seven determinations in a second group of six patients with no or very little dysfunction of the blood-cerebrospinal-fluid barrier only twice cefotaxime was not detectable in lumbar CSF. Concentrations of cefotaxime in 25 determinations of lumbar or ventricular CSF in six patients with bacterial meningitis ranged from 1.1 micrograms/ml to 19.2 micrograms/ml. Treatment with cefotaxime alone was successful in a patient with E. coli meningitis and ventriculitis after infection of a ventriculo-atrial shunt and in another patient with pneumococcal meningitis and penicillin allergy. The other four patients with bacterial meningitis were treated successfully by antibiotics including cefotaxime.

Bacterial Infections

[Encephalitis due to listeria monocytogenes: a complication of immunosuppressive therapy (author's transl)].

Two cases of encephalitis due to Listeria monocytogenes with lethal outcome are presented. The infection occurred during immunosuppressive treatment for panarteritis nodosa and sarcoidosis, respectively. The pathological-anatomical findings were a diffuse purulent meningoencephalitis in the first case and a focal rhombencephalitis with necrotizing inflammation of brainstem and cerebellum in the second one. Listerial infections of the adult are gaining increasing importance as severe complications of immunosuppressive treatment.

Adrenal Cortex Hormones

[Protective effect of Pseudomonas-specific immunoglobulin from the rabbit and of active immunization in experimental Pseudomonas sepsis in mice].

Using the model of an experimental Pseudomonas septicemia in mice, the protective effect of specific antipseudomonal immunoglobulin from rabbits was examined. During bacterial spreading in the bloodstream, a protective effect could be demonstrated under certain conditions. The degree of protection was equivalent to that achieved by active immunization. After bacterial colonization and replication in parenchymal organs no further therapeutic effect could be detected.

Animals

[Dracunculosis].

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Adult

[CSF levels of amikacin following systemic application in patients with slightly and severely impaired blood cerebrospinal barrier (author's transl)].

Levels of amikacin after systemic application of 350 mg were determined by the agar well diffusion method in 12 samples of CSF and serum of 7 patients with bacterial meningitis and in 2 samples of 2 patients with viral meningitis. Only in 2 samples of CSF drawn after the first systemic application of 350 mg i.m. no antibiotic activity was detectable. In 7 specimens of CSF levels of amikacin were greater than or equal to 3 microgram/ml. In 12 tests of CSF of neurosurgical patients with only slight impairment of the blood-CSF-barrier, taken for comparison reasons, only in 6 samples antibiotic activity was found. Only one test revealed CSF-concentration of amikacin higher then 3 microgram/ml.

Adult