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Biomedical subjects

S V Iakovlev

Publications and source records attributed to S V Iakovlev.

At least 19 recordsLinked to original sources

[Clinicomicrobiological monitoring of patients with exacerbation of chronic bronchitis treated with antibacterial drugs].

AIM: To compare clinical and microbiological efficacy of penicillines and macrolids in patients with exacerbation of chronic bronchitis (CB) basing on long-term follow-up after antibacterial treatment. MATERIALS AND METHODS: Twenty patients with exacerbated CB or chronic obstructive pulmonary disease (COPD) received amoxicillin/clavulanic acid (augmentin) while 20 other patients were given macrolides (sumamed or clacide). Clinical efficacy was assessed by the rate of exacerbation regression and duration of recurrence-free period in the course of 12-month follow-up. Bacteriological examination was conducted 3-5 days, 1 month after the treatment and at recurrent exacerbation. RESULTS: Patients on augmentin showed faster regression of exacerbation, earlier remission and higher quality of remission than patients on macrolides. Eradication of etiologically significant pathogens on day 3-5 after therapy with augmentin and macrolides was achieved in 92 and 30% patients, respectively, persistence--in 8 and 70%, respectively. Mean duration of remission was 263 +/- 107.1 and 164.9 +/- 112,2 days, respectively. A correlation was found between duration of recurrence-free period and frequency of eradication and persistence of the agents after antibacterial therapy of CB and COPD. CONCLUSION: Augmentin promotes a significantly earlier regress of exacerbation symptoms and persistent remission. Eradication potential of augmentin in CB/COPD patients is higher than that of macrolides. Long-term post-exacerbation monitoring (12-month follow-up) discovered that recurrence-free period of augmentin-treated patients is much longer than in patients on macrolides.

Adult↗

[Evaluation of efficacy and safety of josamycin (Vilprafen) in the treatment of patients with community-acquired pneumonia].

Clinical and bacteriological efficacy ofjosamycin (Vilprafen), a macrolide antibiotic, was studied in 30 out- and inpatients at the age of 18 to 68 years (the average of 43.4+/-16.7 years old) with nonsevere (PORT) community-acquired pneumonia in the case histories. Josamycin was administered orally in a dose of 500 mg every 8 hours for 7 to 10 days. The treatment course was 5 to 10 days (the average of 7.7+/-1.3 days). The recovery was stated in 28 (93.3%) patients and the pathogen eradication was recorded in 16 (88.9%) patients. Moderate side effects not requiring discontinuation of the drug use were observed in 3 patients. The results of the treatment were indicative of the josamycin high efficacy in the treatment of the patients with nonsevere community-acquired pneumonia.

Adolescent↗

[Staphylococcal pneumonia].

In January to December 2000, a total of 15 (8.8%) patients with staphylococcal community-acquired pneumonia (CAP), 13 (27.7%) patients with staphyloccocal nosocomial pneumonia (NP) that occurred at general units (GU), and 9 (50%) patients with GU that occurred under artificial ventilation (AV) at intensive care units (ICU) were followed up. Meticillin-resistant S. aureus strains were isolated in 6.7, 38.5, and 55.6% of cases, respectively. As compared with pneumococcal CAP, staphyloccocal CAP were more frequently characterized by the severe course of the disease (46.7% versus 15.4%), bilateral lesion (33.3% versus 5.1%), and the presence of complications (66.7% versus 30.8%). Staphyloccocal NP that had occurred at GU, as compared to that at ICU also showed the severe course of the disease (46.2% versus 2.9%), bilateral lesion (30.7% versus 0%), and developed complications (75% versus 25%). Staphylococcal NP developed under AV at ICU had no specific features as compared with NP of another etiology. Oxacillin and first-second-generation cephalosporins remain to be the drugs of choice when meticillin-sensitive S. aureus strains are isolated; lincomycin and erythromycin being alternative agents against these strains. Glycopeptides are the drugs of choice when meticillin-resistant S. aureus strains are isolated, its alernatives are linesolide or rifampicin. High mortality rates due to staphylococcal pneumonia are preserved. These are 7.1% in CAP, 7.7 and 66.7 in staphylococcal NP occurring at GU and under AV at ICU, respectively.

Acute Kidney Injury↗

[Characteristics and clinical value of extended-spectrum beta-lactamases].

The literature data and the findings of the authors' studies on the role of extended-spectrum bata-lactamases (ESBL) in providing the clinical effect in the treatment of infections due to ESBL-producing organisms were analyzed. The analysis allowed to consider the NCCLS recommendations not sufficiently valid. According to these recommendations the ESBL-producing organisms (among E. coli and Klebsiella spp.) should be regarded as resistant to penicillins, cephalosporins and aztreonam. Susceptibility of 62 Enterobacteriaceae strains that were isolated in 4 therapeutic centres of Tomsk, Nazran and Moscow and proved to be ESBL-producing organisms was tested and it was shown that the 3rd and 4th generation cephalosporins could not be referred to a homogenous group. The same was confirmed by the prospective and retrospective investigations of a multiprofile hospital on the clinical and bacteriological efficacies of the 3rd generation cephalosporins and cefepime in the treatment of hospital-acquired infections due to Enterobacteriaceae strains producing ESBL.

Adolescent↗

[The clinical efficacy of ticarcillin/clavulanate in severe pneumonia].

Efficacy of ticarcillin/clavulanate was studied in the treatment of 11 patients with severe community- and hospital-acquired pneumonia in an open controlled trial. The drug was administered in a dose of 3.1 g every 4 or 6 hours depending on the infection severity. When pneumonia was due to Pseudomonas aeruginosa, amikacin was additionally used. The positive clinical effect of ticarcillin/clavulanate was stated in 73 per cent of the patients. The pathogen eradication was stated in all the patients. However, in 2 cases superinfection due to P.aeruginosa developed. Mild adverse effects were observed in 2 cases. It is concluded that ticarcillin/clavulanate is highly efficient in the treatment of patients with severe or complicated pneumonia. In cases with ventilator-associated pneumonia it is advisable to use ticarcillin/clavulanate in combination with an aminoglycoside.

Acute Disease↗