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Biomedical subjects

F Daschner

Publications and source records attributed to F Daschner.

At least 181 records · Page 10Linked to original sources

Bacteraemia in surgical patients with intravenous devices: a European multicentre incidence study. The European Working Party on Control of Hospital Infections.

A survey of the incidence of bacteraemia and the use of intravenous (IV) devices among 10,616 surgical patients was performed in 42 hospitals in eight countries. It was found that 63 per cent of the patients surveyed had an IV device inserted at some time during their hospital stay, with national variations between 40 and 99 per cent. The incidence of device-related thrombophlebitis was 10.3 per cent, with national variations between 7.8 and 28.4. Among the surgical patients not given IV therapy, 1.5/1000 had a bacteraemia, 0.5/1000 of them hospital-acquired. The corresponding figures for patients with a peripheral but no central IV device were 6.9 and 3.7, and for patients with a central venous catheter (CVC) 59.0 and 44.8, respectively. Even though there was a strong correlation between the incidence of bacteraemia and certain diagnoses there was also an independent correlation between it and CVCs or peripheral IV lines. No correlation was demonstrated between the number of catheter days per site for patients with a peripheral IV device, and hospital-acquired bacteraemia. This may be due to the low mean number of catheter days per site that was observed. There was a large and not easily explained national variation in the incidence of bacteraemia in patients with CVCs of between 16 and 108/1000.

Catheterization↗

[Antibiotic prevention in gynecology. Concentrations of ceftizoxime in the serum, myometrium, endometrium and fallopian tubes].

34 patients received an intravenous bolus injection of 2 g ceftizoxime over 5 min at various times before abdominal or vaginal hysterectomy. Ceftizoxime concentrations in myometrium were substantially higher than in salpinges and endometrium. Tissue concentrations of 4 micrograms/g could be maintained for at least 3 hours. The ceftizoxime tissue concentrations attained in myometrium, endometrium and salpinges justify therapeutic studies and controlled prospective clinical trials on the prevention of postoperative wound infections with this antibiotic.

Adult↗

[Single-dose mezlocillin prophylaxis and postoperative morbidity after vaginal hysterectomy: pharmacokinetic and clinical results].

In this prospective, randomized study we evaluated the prophylactic administration of 5 g Meclocillin in a single dose. 100 patients undergoing vaginal hysterectomies were observed. Clinical parameters as well as Meclocillin concentrations in serum and myometrium were compared. We found a sufficient Meclocillin concentration in serum and myometrium 30 minutes after intravenous administration. In the control group (n = 50) 8 patients had a febrile postoperative course whereas there was 1 patient only in the treated group. A more detailed analysis regarding predisposing risk factors, urinary tract infections and pathogens of the vaginal wound secretions is presented. The single dose administration had no significant effect on the incidence of postoperative urinary tract infections. The preliminary result of our study reveals the single dose treatment to be a remarkable alternative to the three-dose-perioperative regimen. Regarding the general question of prophylactic antibiotic treatment at time of vaginal hysterectomy especially individual factors as well as preoperative risk factors have to be taken into account.

Drug Administration Schedule↗

[Concentrations of cefotiam in serum, heart valves, muscle and adipose tissue during heart surgery].

In 20 patients undergoing heart surgery, concentrations of cefotiam (Halospor) in plasma, heart valves, muscles and subcutaneous tissue were determined after intravenous injection of 2 g. Within 5 h cefotiam serum concentration declined from 18 micrograms/ml to 7 micrograms/ml, the concentrations in heart valves declined from 22 micrograms/g to 4 micrograms/g. In heart valves the concentrations during heart surgery were high enough to inhibit most Staphylococcus aureus, E. coli and Klebsiella strains.

Adipose Tissue↗

[Comparative studies on the bioavailability of 2 amoxicillin preparations].

The bioavailability of alpha-amino-4-hydroxybenzyl-penicillin (amoxicillin) was investigated after administration of two different preparations. As test substance Sigamopen tablets were given and compared with a standard-preparation on the German market. Both preparations contained 750 mg amoxicillin. No significant differences were found in the serum concentrations, in the bioavailability or other pharmacokinetic parameters. The results obtained are in agreement with those known in the literature. Therefore, both preparations were regarded as bioequivalent.

Adult↗

[Cefotaxim--an alternative in the treatment of purulent meningitis in children?].

Cefotaxim was administered to ten children with purulent meningitis. All isolated micro-organisms were highly sensitive to it in serial dilution, except for one case, and were quickly removed from blood and CSF by the administration of cefotaxim alone. Blood and CSF concentrations measured in eight children were much above the minimal inhibitory concentration for the particular micro-organism. Thus cefotaxim has a high antibacterial activity and satisfactory CSF passage in purulent meningitis caused by sensitive, especially gram-negative, bacteria and is well suitable for therapy, if penicillins alone or combined are not applicable or effective.

Cefotaxime↗

[Control of serum levels of tobramycin and amikacin during clinical routine treatment conditions (author's transl)].

576 serum levels at peak and before the next dosage (end level) were determined during clinical treatment conditions using radioimmunoassay in 131 patients treated with tobramycin or amikacin because of life-threatening infections. Only 42.8% of tobramycin serum peak levels were within the therapeutic range. 3.6% were potentially toxic, however, 53.6% were in a subtherapeutic range. After amikacin administration only 25% of serum peak levels were in a subtherapeutic range. 54.2% were therapeutic and 20.8% were potentially toxic. The main reason for increased peak and end serum levels was diminished renal function. Infusion treatment with more than 3 1/24 hrs lowered serum peak levels of tobramycin by 38% and of amikacin by 31%. Single doses of 80 mg of tobramycin lead to subtherapeutic concentrations too frequently, whereas single doses of 500 mg of amikacin too frequently lead to potentially toxic serum levels. Control of serum levels during aminoglycoside treatment is recommended particularly in patients at risk with life-threatening infections.

Amikacin↗

Urinary-tract infection and bacteraemia in hospitalized medical patients--a European multicentre prevalence survey on nosocomial infection.

A co-ordinated survey of 3899 medical patients in 169 wards, performed simultaneously in eight countries, showed a point-prevalence of urinary-tract infection (UTI) and bacteraemia of 12.6 and 1.6 per cent, respectively. One-half of the infections were acquired after the patients' admission. The bacteriological patterns of hospital- vs community-acquired infections were different, but showed no unexpected features. Antibiotic treatment was recorded in 22.3 per cent of the patients in this study, urinary-tract disinfectants, sulphonamides or penicillins being used in 95 per cent of those treated for UTI. The overall prevalence of urinary-tract drainage was 11.0 per cent with no significant difference between the two sexes. At ward level the rate of catheterized patients varied from below 5 per cent to more than 25 per cent, indicating--besides variations in the ward populations--differences in policies. The association between nosocomial UTI and the presence of an indwelling catheter and/or female sex was confirmed, while high age appeared to be a secondary risk factor among catheterized patients. The prevalence of nosocomial bacteraemia in patients with UTI was five times higher than in those without urinary-tract involvement, and a significant part of the nosocomial cases of both UTI and bacteraemia was clearly device-related. Guidelines for the use of indwelling catheters should be restrictive and provide for prompt removal. When introduced and followed they will effectively reduce nosocomial UTI and bacteraemia.

Age Factors↗

[Nosocomial infections in rooming-in system: results of a two-year study].

Nosocomial infections of 1356 mothers and their newborn have been analyzed and compared in three different regimens for postnatal care of newborn (rooming-in service, mixed service and central newborn nursery). The average nosocomial infection rate of mothers was significantly lower in the rooming-in service as compared to the newborn nursery. Most common nosocomial infections of mothers were urinary tract infections, endometritis, wound infection, enteritis and mastitis; in newborn enteritis, oral candida infections, panaritium, conjunctivitis and staphylococcus skin infections. Staphylococcal infection of newborn were higher in the newborn nursery as compared to the rooming-in service. Epidermic nosocomial infections (e.g. enteritis, candida infections) occurred more often in the newborn nursery as compared to the mixed system and rooming-in service. There was an increased risk of cross infections from mothers with wound infection, endometritis and mastitis to their children.

Cross Infection↗

[Experimental and clinical investigations on reapplicability of resterilized intravascular catheters (author's transl)].

Catheters for cardiovascular and other angiographic investigations can be resterilized by ethyl-oxide. The procedure of sterilisation has to be controled permanently. Reapplicability of catheters has become quite common because of the high price of new catheters. In spite of optimal resterilisation and permanent controll some patients still get fever attacks, because endotoxins cannot be eliminated by this method.

Cardiac Catheterization↗

[Nosocomial infections in an operative intensive care unit. Results of a four year prospective study (author's transl)].

The average nosocomial infection rate during a four year prospective study period was found to be 26.4%. Most common hospital acquired infections were urinary tract infections, pneumonia, septicemia, infections of the skin and wound infections. The most common isolated organisms were: Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Enterococci and Klebsiella pneumoniae. Infection control programs reduced the infection rate by 32%.

Cross Infection↗