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Biomedical subjects

Y Deboscker

Publications and source records attributed to Y Deboscker.

7 recordsLinked to original sources

[Prospective, randomized, controlled study of imipenem-cilastatin versus cefotaxime-amikacin in the treatment of lower respiratory tract infection and septicemia at intensive care units].

In a multicentre, prospective, controlled trial 211 patients with suspected septicaemia or pneumonia were allocated at random to either imipenem-cilastatin 500 mg 8-hourly or cefotaxime 1 g 6-hourly combined with amikacin 5 mg/kg 8-hourly. The treatments were administered for at least 5 days. Seventy patients on imipenem and 70 patients on cefotaxime-amikacin were assessable for comparison. There were no statistically significant differences between the two groups in underlying pathology and in the clinical results obtained: septicaemia 20/26 patients of the imipenem group and 20/25 patients of the cefotaxime-amikacin group were cured; pneumonia 38/44 patients of the imipenem group and 34/45 patients of the cefotaxime-amikacin group were cured. There were also no differences in the initial organisms and in the bacteriological cure rate, except for Pseudomonas aeruginosa. At the moment, imipenem administered alone is as effective as the cefotaxime-amikacin combination in the treatment of septicaemia or pneumonia in intensive care patients, with the exception of P. aeruginosa pneumonia in patients under assisted ventilation.

Adult↗

[Bronchial diffusion of piperacillin in 18 intensive care patients].

Eighteen patients (13 under mechanical ventilation) in an intensive care unit received piperacillin for pneumonia (7 cases) or bronchial infection (11 cases), related to Haemophilus influenzae (7), Streptococcus pneumoniae (4) or miscellaneous pathogens (7) including Staphylococcus, E. coli, Klebsiella pneumoniae and Proteus mirabilis. Each patient was given 2g piperacillin intravenously every six hours. Concentrations in serum and bronchial secretion samples were assayed by the agar diffusion technique using a susceptible strain of Bacillus subtilis ATCC 6633. Maximum concentrations were 157 micrograms/ml in serum and 3.60 micrograms/ml in bronchial secretions. These results are similar to those obtained with the same dosage by 0. Cars in serum (150 micrograms/ml) and by G.E. Marlin in the bronchial secretions (3.78 micrograms/ml). They approximate those published for other penicillins with the same dosage.

Bacterial Infections↗

[Use of moxalactam in intensive care units: clinical and bacteriological results related to serum and bronchial concentrations ].

Twenty-patients (14 with mechanical ventilation) received moxalactam in an intensive care unit for pneumonia (3 cases), empyema (5 cases), bronchopneumonia (8 cases), bronchopneumonia with bacteremia (4 cases), 23 organism were isolated and 16 were hospital-acquired: Staphylococcus (3), Escherichia coli (1), Klebsiella-Enterobacter-Serratia (5), Proteus (3), Aeruginosa (2), Acinetobacter (2), These patients received moxalactam at the dosage of 500 mg/8H, 5 at 1 g/12H and 13 at 1 g/8H. Daily dosage ranged between 25 and 50 mg/kg; mode of administration was IM (16) or IV infusion pump (5) and mean duration of treatment was 12 days (range 6-21). Serum and bronchial secretion samples were assayed by the agar diffusion technique utilizing a susceptible strain of enterobacter cloacae (0.06 microgram/ml) as assay organism. At 1 h, mean serum concentrations were 31.5 micrograms/ml after 1 g IM every 12H, 54.9 micrograms/ml after 1 g IM every 8H and at 30 mn after the end of the infusion, serum concentrations were 54.2 micrograms/ml. At the same time, bronchial secretion concentrations were respectively 2.1 micrograms/ml, 5 micrograms/ml and 3.7 micrograms/ml. Clinical cures were obtained in 16 (80%) and bacteriological cures occurred in 14 (70%); of the 12 hospital - acquired infections patients, 8 experienced clinical cures (66%) and the emergence of the following organisms was observed during moxalactam treatment: Staphylococcus (1), Enterococcus (1), Pseudomonas aeruginosa (1), Acinetobacter (3), For the 20 patients, we noted 4 adverse effects: pruritic morbilliform eruption (1), thrombocytosis (1), eosinophilia (2), To avoid failures, the usefulness of routine combinations with amyglycosides is discussed for the cases of hospital - acquired infections.

Adult↗