Biomedical subjects

F D Daschner

Publications and source records attributed to F D Daschner.

186 records · Page 11Linked to original sources

PubMedDate not supplied

Combination effect of meropenem with aminoglycosides and teicoplanin on Pseudomonas and enterococci.

The in vitro activity of meropenem, a new carbapenem, and the combination effect with netilmicin, tobramycin, gentamicin, and teicoplanin against Pseudomonas spp. and enterococci was studied. Meropenem showed very good in vitro activity against Pseudomonas aeruginosa (MIC90 2 mg/l) and good to moderate activity against Pseudomonas putida (MIC90 4 mg/l) and Enterococcus faecalis (MIC90 8 mg/l). Aminoglycosides were highly active against P. putida (MIC90 0.5 mg/l), but showed only moderate activity against P. aeruginosa. The synergistic effect of meropenem was shown in combination with teicoplanin against E. faecalis (40%). No Pseudomonas strains were inhibited by the synergistic effect of meropenem with aminoglycosides. No antagonism occurred with any of the combinations.

Aminoglycosides↗

PubMedDate not supplied

Cost-effectiveness of ceftriaxone 1 g vs second-generation cephalosporins in the treatment of pneumonia in general medical wards in Germany.

The cost-effectiveness of ceftriaxone 1 g in the treatment of pneumonia in general medical wards was compared with that of second-generation cephalosporins. A total of 1,706 patients were treated with either a second-generation cephalosporin (cefotiam, cefuroxime) or ceftriaxone (single daily dose of 1 g), and 604 in each group were included in a matched-pair analysis. Cure or improvement in response to monotherapy was observed in 81.4% of patients on cefuroxime/cefotiam vs 91% of those on ceftriaxone (P < 0.0001). Adverse events occurred with equal frequency in both groups (1.9%). In terms of mean hospital costs for antimicrobial medication, the staff required to administer it as well as laboratory and X-ray examinations, effective treatment with ceftriaxone is DM 193/$ 105 (25%) less expensive than effective treatment with a second-generation cephalosporin (P < 0.001). From the perspective of the health insurance, the costs for a patient treated with ceftriaxone are DM 3,910/$ 2,140 vs DM 4,392/$ 2,400 for a patient treated with a second-generation cephalosporin (March 1998: USD 1 = DM 1.83).

Adolescent↗

PubMedDate not supplied

Cost-effectiveness of ceftazidime or imipenem/cilastatin versus ceftriaxone + aminoglycoside in the treatment of febrile episodes in neutropenic cancer patients in Germany.

A three-pronged cost-effectiveness analysis of the treatment of febrile episodes in neutropenic cancer patients was conducted. It included a review of 37 randomized, controlled studies in the MEDLINE and EMBASE databases (1980-1996). Clinical outcomes as well as costs of treatment with imipenem/cilastatin, ceftazidime and ceftriaxone + aminoglycoside were compared. Primary therapy and modification, respectively, were successful in 62 and 27% of patients treated with imipenem/cilastatin, in 56 and 31% with ceftazidime and in 41 and 13% with ceftriaxone + aminoglycoside. From the perspective of a 1,800-bed teaching hospital, the average overall cost per successfully treated patient was DM 7,475 with imipenem/cilastatin, DM 7,810 with ceftazidime and DM 8,963 with ceftriaxone + netilmicin (DM 1 = USD 0.56; 7/97). The costs for the German national economy were imipenem/cilastatin DM 23,828, ceftazidime DM 24,985 and ceftriaxone + netilmicin DM 29,838.

Ceftazidime↗

PubMedDate not supplied

Report of a symposium on use and abuse of antibiotics worldwide.

A collaborative symposium of the Quality of Care and Technologies Programme of the World Health Organization's Regional Office for Europe and the Department of Hospital Epidemiology of the University Hospital, Freiburg, was held in Freiburg, FRG, in September 1988 to consider the use and abuse of antibiotics worldwide. Participants from developing countries provided estimates of use of antibiotics and problems of resistance in their countries. Because much of the information either is anecdotal or may not be representative of the vast, heterogenous populations in these countries, it is difficult to provide exact guidelines for the use of antibiotics. There is a need for better etiologic definition of the causes of acute respiratory tract infection and diarrheal disease and for surveillance of resistant bacterial strains. Because of the difficulty of making an etiologic diagnosis, a set of empiric guidelines has been developed for diagnosis and management of common conditions. Recommendations for the use of antibiotics must take into account the economics, medical manpower, social constraints, and emergence of resistant bacteria in both developed and developing countries. There is a need to establish a coordinated, worldwide network to obtain representative data and to organize clinical trials pertinent to the conditions of both developed and developing countries to define the best antimicrobial agent(s), the dosage, and duration of treatment for specific conditions.

Anti-Bacterial Agents↗

PubMedDate not supplied

In vitro susceptibility to everninomycin of gram-positive nosocomial pathogens isolated from intensive care units in Germany.

BACKGROUND: Gram-positive bacteria are increasingly found to be causative pathogens in nosocomial infections, and the occurrence of vancomycin resistance in enterococci as well as staphylococci has prompted the investigation of alternative antimicrobial agents active against these strains. Everninomycin, a new oligosaccharide antibiotic, has excellent in vitro activity against gram-positive bacteria, including those resistant to vancomycin. However, avilamycin, a related compound, has been used in Europe as a growth promoter in animal food for years and concern has been raised that cross-resistance in clinical isolates may arise. METHODS: We studied a collection of 268 nosocomial gram-positive isolates from intensive care unit patients with nosocomial pneumonia, urinary tract infection and sepsis, using standard in vitro susceptibility testing. RESULTS: It could be shown that all species tested were exquisitely sensitive to everninomycin (MIC(90) of 0.38 microg/ml for Staphylococcus aureus, 0.5 microg/ml for enterococci and 0.75 microg/ml for coagulase-negative staphylococci). Furthermore, no difference could be observed between methicillin-resistant and methicillin-sensitive S. aureus or between Enterococcus faecium and Enterococcus faecalis. CONCLUSIONS: These results suggest that everninomycin is a promising antibiotic for the treatment of nosocomial infections in intensive care unit patients and that the use of a related substance as an additive in animal food has not yet promoted resistance in clinical isolates.

Aminoglycosides↗

PubMedDate not supplied

Penetration of gentamicin into heart valves, subcutaneous and muscular tissue of patients undergoing open heart surgery.

Concentrations of gentamicin in plasma, heart valves, subcutaneous tissue and muscle were determined in 38 patients undergoing open heart surgery. Gentamicin reached peak levels in plasma and tissue within 60 min after a 5 min intravenous bolus injection of 1.5 mg/kg body weight. Subcutaneous and muscle concentrations varied between 0.51 microgram/g and 2.1 microgram/g. Gentamicin peak concentrations in cardiac valvar tissue wre 3.6 mug/g between 2 and 5 hours after administration; gentamicin heart valve concentrations varied between 1.2 microgram/g and 1.59 microgram/g. Gentamicin tissue concentrations during open heart surgery are high enough to inhibit most Klebsiella/Enterobacter and Staphylococcus aureus and epidermidis strains. However Gentamicin heart valve concentrations do not exceed 1.5 microgram/g for more than 1 h, which may explain treatment failures of patients with endocarditis.

Cardiac Surgical Procedures↗