PubMed Health⌕ Search

Biomedical subjects

V P Iakovlev

Publications and source records attributed to V P Iakovlev.

At least 37 records · Page 2Linked to original sources

[Use of ceftriaxone in the prevention of postoperative purulent complications after surgery on the stomach and small intestine].

Ceftriaxone was administered intravenously in a single dose of 1.0 g 15 minutes prior to surgical intervention for peptic ulcer and gastric or duodenum tumor in 31 patients at the age of 33 to 74 years. In all the patients primary adhesion of the surgical wound was recorded. No signs of local or general infection were observed. The indices of the total blood count, urinalysis and blood biochemical analysis came to normal by the 5th or the 7th day of the postoperative period. The levels of ceftriaxone in the blood, urine, stomach wall, small intestine tissues and subcutaneous fat were evaluated. The indices of the cellular and humoral immunity in the pre- and postoperative periods in the patients prophylactically treated with ceftriaxone were analyzed.

Adult↗

[Antimicrobial chemotherapy in patients with pyo-septic diseases in intensive care units].

The analysis of the treatment of 900 patients with large festered wounds of various genesis and location for the period from 1973 to 1998 years in the intensive care department has shown, that infection of respiratory ways is encountered in 30% of cases (in patients with nonsporeforming anaerobic bacteria--in 11-12%), bacteriuria--in 70-80%, bacteriamia--in 75% of patients with sepsis. In acute pyogenous diseases of soft tissues microbes from the wounds in monoculture were isolated out in 83.3% of cases, associations of gram-positive and gram-negative bacteria--in 16.7%, in chronic pyogenous diseases of soft tissues--in 60 and 40% of cases, respectively. In sepsis associations of gram-positive and gram-negative microbes were isolated in 55.6% of cases. Most often (91%) pathogenic staphylococcus was found in hemocultures. Uring in 62% of cases contained association of gram-positive and gram-negative microorganisms, in sputum gram-positive microflora in monoculture (69%) prevailed. In the group of patients with peritonitis, phlegmon of the anterior abdominal wall, diabetic phlegmon and gangrene, crush syndrome the association of anaerobic and aerobic microflora (from 57.1 to 98.8%) prevailed in the wounds. Application of up-to-date antimicrobial means in the intensive care unit resulted in a decrease of mortality rate in sepsis and complicated course of wound infection up to 23%, and in anaerobic nonsporeforming infection--up to 15%.

Anti-Bacterial Agents↗

[The results of a multicenter study of the comparative activity of cefepime and other antibiotics against the causative agents of severe hospital infections (the Micromax program)].

A multicentre trial was performed on the activity of cefepime in comparison with ceftazidime, ceftriaxone, piperacillin/tazobactam, imipenem and ciprofloxacin against severe hospital infection pathogens in intensive care units. The isolates of Escherichia coli and Proteus spp. from the majority of the centres were highly susceptible to the antibiotics (90 to 100 per cent of the isolates). In some centres up to 40 per cent of the isolates produced ESBL. The isolates of Klebsiella spp. were characterized by lower susceptibility, in some centres the frequency of the strains producing ESBL exceeded 90 per cent, by the MIC geometric mean cefepime was superior to the third generation cephalosporins, the frequency of resistance to ciprofloxacin ranged from 0 to 31 per cent, no resistance to imipenem was recorded. The frequency of resistance to the third generation cephalosporins and piperacillin/tazobactam in Enterobacter spp., Serratia spp., Citrobacter spp., Morganella spp., and Providencia spp. ranged from 10 to 52 per cent, the resistance to cefepime equaled 0-11 per cent, 0 to 17 per cent of the isolates were resistant to ciprofloxacin, some isolates were resistant to imipenem. As for the nonfermenting microorganisms their resistance to all the antibiotics tested was comparatively high and markedly differed in various centres. As a whole, 7 per cent of all the isolates of the nonfermenting organisms was resistant to cefepime, 10 per cent was resistant to imipenem, 17 per cent was resistant to ceftazidime, 21 per cent was resistant to piperacillin/tazobactam and 36 per cent was resistant to ciprofloxacin.

Acute Disease↗

[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↗

[Clinical and laboratory study of cefodizime (Modivid) in prophylaxis and treatment of surgical patients].

The results of the clinical and laboratory study of the efficacy of the prophylactic and therapeutic use of cefodizime (modivid) in patients with chronic calculous cholecystitis and burns are presented. Expediency of the preoperative prophylactic use of the drug and its significance in the treatment of infectious complications of the burn disease were verified. The immunological investigation gave evidence of an increase of the phagocytosis functional activity when cefodizime (modivid) was used prophylactically in cholecystectomy.

Adolescent↗

[Efficacy of lomefloxacin and ofloxacin in complex therapy of infections in patients with burns].

The experience with lomefloxacin and ofloxacin respectively in the complex therapy of 26 and 40 patients with burns is described. The drugs were shown to be highly active in the treatment of burn wound infections and infectious complications of burn disease. The clinical efficacy of lomefloxacin and ofloxacin amounted to 88 and 77.5 per cent and the bacteriological efficacy amounted to 81 and 80 per cent respectively.

Adolescent↗

[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↗

[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↗

[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↗