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Biomedical subjects

D M Poretz

Publications and source records attributed to D M Poretz.

At least 37 records · Page 2Linked to original sources
PubMed1983

Ceftriaxone therapy of serious bacterial infections.

Ceftriaxone, a broad spectrum cephalosporin with a markedly extended half-life, was administered to 68 patients with 71 infections in an open trial. Sixty-three infections (89%) had a satisfactory clinical response with eradication of bacteria present at the initiation of therapy in 62 infections (87%). The eight treatment failures correlated well with the development of resistance to ceftriaxone during therapy in Enterobacter and Pseudomonas species (two cases) and with superinfection with Bacteroides fragilis (three cases). Treatment was discontinued in eight patients because of unwanted effects. Serious side effects included leukopenia, rash, fever, and enterocolitis.

Adolescent↗
PubMed1983

Ceftazidime in patients with Pseudomonas infections.

Ceftazidime was administered to 41 patients with serious infections caused by Pseudomonas aeruginosa (24 cases) and other bacteria (17 cases). The clinical response rate of pseudomonas infections (88%) was similar to that of other bacteria (94%) with microbiological eradication of 83% of initial pseudomonas isolates compared to 82% of non-pseudomonas strains. The development of resistance to ceftazidime during therapy was observed in 3 cases (Enterobacter agglomerans, Enterobacter cloacae, and Ps. aeruginosa), and superinfection by a resistant Enterobacter agglomerans occurred in one case. Adverse reactions of clinical significance included two cases of leukopenia and one case each of azotaemia, diarrhoea (Clostridium difficile toxin positive), and rash.

Abscess↗
PubMed1983

Piperacillin therapy for Pseudomonas infections.

Piperacillin, a new broad spectrum semisynthetic penicillin derivative, was administered to 22 patients with 25 Pseudomonas aeruginosa infections. All initially responded favorably, although five complicated urinary tract infections and two infections involving prostheses relapsed. In 15 cases, microbiologic eradication of the Pseudomonas was achieved. Failure to achieve a clinical cure was correlated in all cases with the inability to eradicate the organism, which was the result of development of in vitro resistance to piperacillin during therapy (four cases) and of underlying disease impairing host responses. Adverse reactions to piperacillin included leukopenia (eight cases) and nephrotoxicity (two cases).

Adolescent↗
PubMed1983

Ceftazidime therapy of serious bacterial infections.

Ceftazidime, a new broad-spectrum cephalosporin, was administered to 30 patients with serious bacterial infections in a randomized dosing trial with daily doses of 1.5 or 3 g. Both regimens were equally efficacious, with satisfactory clinical responses in 28 instances (93%) and microbiological eradication of 79% of initial bacterial isolates. The development of resistance to ceftazidime during therapy was observed in three cases (Enterobacter agglomerans, Enterobacter cloacae, and Pseudomonas aeruginosa) and superinfection by a resistant Enterobacter agglomerans strain occurred in one case. Adverse reactions of clinical significance included one case each of leukopenia, azotemia, diarrhea (Clostridium difficile toxin positive), and rash.

Adolescent↗
PubMed1983

Ceftriaxone therapy of bone and soft tissue infections in hospital and outpatient settings.

Ceftriaxone, a broad-spectrum cephalosporin with a markedly extended half-life, was administered to 100 patients with 56 bone and 44 soft tissue infections. Sixty-eight received 1 g twice daily, and 32 received 2 g once daily intravenously. Overall, 91% had a satisfactory clinical response, with similar efficacies in both treatment regimens. In six patients, failure to achieve a cure correlated well with the development of resistance to ceftriaxone during therapy in Enterobacter and Pseudomonas species (two cases) and with superinfection with Bacteroides fragilis (four cases). In 41 patients, intravenous drug therapy was continued after discharge from the hospital. In this group, 1,093 patient-days of hospitalization were saved, amounting to $150,020 in cost savings. The prolonged half-life facilitated the administration of ceftriaxone in this setting.

Adolescent↗
PubMed1983

Imipenem versus moxalactam in the treatment of serious infections.

Imipenem (formerly imipemide, N-formimidoyl thienamycin, or MK0787) was compared to moxalactam in a randomized therapeutic trial involving 39 evaluable patients with serious bacterial infections. Of those treated with imipenem, 89% were cured or improved versus 60% for moxalactam (P = 0.06). Although mucocutaneous fungal infections occurred in both groups (25 and 10%, respectively), Streptococcus faecalis superinfection was seen in two patients in the moxalactam group only. Adverse drug reactions occurred with both drugs, although bleeding occurred in three patients treated with moxalactam.

Adult↗
PubMed1982

Intravenous antibiotic therapy in an outpatient setting.

A program has been developed for the outpatient administration of parenteral antibiotics. To date, more than 150 patients with osteomyelitis, septic arthritis, pyelonephritis, endocarditis, and other infections have been treated. Antibiotic solutions were prepared in the hospital pharmacy and given to the patient to be kept refrigerated at home until used. Patients administered their own antibiotics by means of a heparin lock, which was replaced every four days or when necessary. Complications were infrequent. Many patients were able to return to work while receiving therapy; others enjoyed the comfort of being at home. Cost reductions were substantial, calculated to be at least $142 a day, or the charge for a semiprivate room in 1981. In addition to the cost savings, critically needed hospital beds were freed for more acutely ill patients.

Adolescent↗