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Biomedical subjects

V P Iakovlev

Publications and source records attributed to V P Iakovlev.

At least 19 recordsLinked to original sources
PubMed1998

[Multicenter open randomized trial of meropenem in comparison to ceftazidime and amikacin used in combination in severe hospital infections].

Clinical efficacy and tolerance of meropenem were estimated by comparison with those of ceftazidime and amikacin used in combination in the therapy of hospital infections of the lower respiratory tract, skin and soft tissues, intraabdominal and gynecologic infections, urinary tract infection and sepsis. 48 patients were given meropenem in a dose of 1 g every 8 hours for 3-14 days (the average of 9 days). 47 patients were subjected to the routine combined therapy: ceftazidime in a dose of 1 g every 8 hours and amikacin in a dose of 0.5 g every 12 hours for 2-14 days (the average of 9 days). The patient groups were comparable by the age, nature and severity of the infection and the condition (the mean APACHE II of 9.1 and 8.9). By the end of the treatment a positive clinical effect (recovery and improvement) was observed in 47 patients (97.9 per cent) treated with meropenem and in 41 patients (89.1 per cent) subjected to the combined therapy. The infection relapse within 4 weeks after the treatment completion was recorded in 3 patients in every group. Before the treatment 133 microbial strains were isolated from the patients. 121 of them were susceptible to meropenem (91.1 per cent), 111 to amikacin (83.4 per cent) and 90 to ceftazidime (67.7 per cent). The difference between meropenem and ceftazidime was significant (p = 0.0005). Eradication of the primary pathogens at the background of the meropenem therapy was stated in 41 out of 44 patients (93.2 per cent) and that of the combined therapy in 38 out of 43 patients (88.4 per cent). The microbiological relapse after the treatment completion was recorded in 3 and 2 patients, respectively. Side effects were observed in 8.3 per cent of the patients treated with meropenem and in 10.6 per cent of the patients subjected to the combined therapy. The trial results were indicative of the meropenem high efficacy and good tolerance and of the possible use of the drug in the monotherapy as an alternative of the routine combined therapy of severe hospital infections.

Adolescent↗
PubMed1997

[Clinico-laboratory study of piperacillin/tazobactam in the treatment of patients with would infection].

Piperacillin/tazobactam (P/T) or tazocin was used in the treatment of 40 patients with soft tissue purulent necrotic wounds of various genesis and localization. In the majority of the patients the affection was of recurring nature. P/T was administered in a dose of 4.5 g 3 times a day for 1 to 14 days (mainly for 8 to 10 days) as 30-minute intravenous infusions. The clinical effect of the treatment was stated in 36 patients (90 per cent). In 3 out of 8 patients with diabetes mellitus the treatment failed. In 1 patient the treatment was discontinued after the first dose because of asphyxia and a short-term decrease of the arterial pressure. Among 105 microbial strains isolated from 75 patients 64 were highly susceptible to P/T, 33 were moderately susceptible and 8 were resistant. 76.3 per cent of the isolates produced beta-lactamase, 66.3 per cent of them were susceptible to P/T. 54 gram-positive and gram-negative strains were isolated from 40 patients. 16 out of the 54 strains were isolated as monocultures and the others as associations. After the treatments the pathogen eradication and the pathogen eradication followed by superinfection were stated in 26 patients (66.7 per cent). In 11 patients (28.2 per cent) the pathogen persistence was observed at the background of the clinical improvement in the majority of the patients. The relapses were recorded in 2 patients (5.1 per cent).

Adolescent↗
PubMed1997

[The pharmacokinetics of fluoroquinolones in different diseases].

A literature review on the pharmacokinetic characteristics of fluoroquinolones in the treatment of patients with various diseases such as diseases accompanied by hepatic insufficiency, mucoviscidosis, diseases in elderly patients, lower respiratory tract infection, septicemia, skin infection and others was analyzed. Infections requiring correction of the routine treatment regiments are indicated.

Anti-Infective Agents↗
PubMed1997

[Pefloxacin mesylate--clinical effectiveness in various forms of infectious-inflammatory diseases].

Pefloxacin mesylate is a broad spectrum fluoroquinolone active against pathogens with multiple resistance. Due to its high therapeutic efficacy (at last 90 per cent) and good tolerance pefloxacin mesylate is considered as the most promising drug in the therapy of severe infections and infections difficult for the treatment such as wound infection, meningitis and particularly perilous infections. Prolonged pharmacokinetics and high bioavailability of the drug provided its administration in the treatment of in- and outpatients with severe infection twice a day in a daily dose of 0.8 to 1.2 g. Pefloxacin proved to be a drug of choice in the treatment of infection due to intracellular pathogens.

Anti-Infective Agents↗
PubMed1996

[Use of aztreonam for the purpose of preventing postoperative purulent complications].

The efficacy of the prophylactic use of azthreonam, a monocyclic beta lactam antibiotic, was studied in 20 patients operated for liver diseases. The drug was administered intramuscularly in a dose of 1 g 30 minutes prior to the operation. During the postoperative period the drug was administered in a dose of 1 g 4-5 times a day for 4 to 5 days. The clinical effect in all the patients was good: no elevation of the body temperature above 37.5 degrees C and no suppuration of the operation wound. Adverse reaction to the treatment were not observed. 135 clinical isolates were tested for the susceptibility to azthreonam. The most susceptible gram-negative bacteria were the following: E coli (100 per cent), P. mirabilis (100 per cent), M. morganii (100 per cent), P. rettgeri (100 per cent) and Citrobacter sp. (84 per cent). P. aeruginosa, Acinetobacter, P. vulgaris and Enterobacter were less susceptible (64, 50, 50 and 47.5 per cent respectively). All the S. aureus isolates were resistant.

Aztreonam↗
PubMed1996

[Ten-year experience with the use of ofloxacin in the treatment of wound infection].

The experience with ofloxacin used for 10 years from 1986 to 1995 in the complex therapy of 208 patients with wound infection complicated in 51 patients (24.5 per cent) by respiratory tract infection such as purulent tracheobronchitis or pleuropneumonia was generalized. In 28 patients (13.5 per cent) persistent bacteriuria not susceptible to the routine drugs was stated. The clinical and bacteriological efficacies of ofloxacin in the group of the patients with noncomplicated purulent wounds of the soft tissues amounted to 85-91 and 74-80 per cent respectively. In the group of the patients with wound infection complicated by respiratory or urinary tract infection the clinical and bacteriological efficacies equaled 94-100 per cent. The appetite disorder, epigastric pain or nausea were rare. Only in 3 cases the adverse reactions required the treatment discontinuation. Despite the use of ofloxacin for many years, the susceptibility of the main causative agents of surgical infections to the drug remained high: Staphylococcus epidermidis 93.3 per cent, Staph.aureus 94.5 per cent, Pseudomonas aeruginosa 96.5 per cent, Escherichia coll 100 per cent, Proteus spp. 100 per cent, Enterobacter spp. 100 per cent, Acinetobacter spp. 82.3 per cent and Klebsiella spp. 88.8 per cent. The successive use of ofloxacin, at first intravenously for 3-5 days and then orally in the form of tablets for 3-5 days, in the treatment of 15 patients with wound infections of various genesis and localization subjected to osteoplastic reconstructive operations provided positive effects in all the cases and was economically advantageous.

Administration, Oral↗
PubMed1996

[Ofloxacin in comprehensive treatment of infections in burn patients].

The experience with ofloxacin in the prophylaxis and treatment of infected burn wounds in 40 patients was investigated. High clinical and microbiological efficacy of the drug was stated (82.5 and 83 per cent respectively). The highest efficacy of ofloxacin was observed when the burned area did not exceed 25 per cent of the body surface. It was concluded that the prophylactic use of the drug during acute burn toxemia was not expedient.

Adult↗
PubMed1996

[Use of pefloxacin in the treatment of infected burn wounds].

The efficacy of a home-made pefloxacin was estimated in clinico-laboratory trials including 25 patients with wound infection. The fluoroquinolone was used in a dose of 400 mg administered orally twice a day for 4-16 days. Good and satisfactory results were stated in 24 patients (96 per cent). The isolates from the patients were mainly susceptible to the drug (86.2 per cent). The bacteriological efficacy amounted to 92 per cent. No side effects to the use of pefloxacin were observed.

Adolescent↗
PubMed1996

[Use of cefpirome in the treatment of patients with skin and soft tissue infections].

The efficacy of cefpirome was estimated in the treatment of 25 patients: 15 patients with pyo-necrotic wounds of the soft tissue of various genesis and localization and 10 patients with deep thermal burns involving 8 to 40 per cent of the body surface. The clinical and bacteriological efficacies of the treatment in the patients with the wound infection amounted to 100 and 80 per cent respectively. In the patients with the burn infection the respective values were 90 and 80 per cent. The drug tolerance was good. Adverse reactions were observed in 1 patient. Bolus intravenous administration of the drug was preferable by comparison with the injections.

Adolescent↗
PubMed1995

[Effectiveness of cefmetazole in treatment of wound infection].

The cefmetazole efficacy was studied in an open non-comparative clinical trial in the treatment of 40 patients with wound infections. The clinical results were excellent and good in 90 per cent of the cases. In 2.5 per cent of the cases the treatment failed. In 7.5 per cent of the cases the results could not be evaluated. The bacteriological efficacy of cefmetazole was equal to 80 per cent. The drug tolerance was good and only in 3 patients allergic reactions were observed. No hepatotoxic or nephrotoxic effects were recorded. The results were indicative of the advisability of the cefmetazole use in the treatment of wound infections.

Adolescent↗
PubMed1995

[Use of imipenem in the treatment of patients with surgical infection].

The efficacy of thienam, a product of Merck, Sharp and Dohme (USA) composed of imipenem and cylastatin was studied in the treatment of 52 patients with surgical infection. In 48 and 4 patients the drug was used therapeutically and prophylactically respectively. When the drug was used therapeutically the recovery and improvement were observed in 41 out of 44 patients (93.2 per cent), 4 patients being excluded from the treatment group because of adverse reactions such as hyperthermia and skin eruption. When the drug was used prophylactically the recovery and improvement were stated in all the 4 patients. The pathogens were eradicated in the wound in 40 patients (91 per cent). 114 clinical isolates were tested and the imipenem resistance was detected only in 6.5 per cent of the Staphylococcus aureus strains, in 20 per cent of the Pseudomonas aeruginosa strains and in 50 per cent of the P. mirabilis and P. vulgaris strains. All the isolates of Escherichia coli, Enterobacter, Acinetobacter and Citrobacter were susceptible or moderately susceptible to imipenem.

Adult↗