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Biomedical subjects

G K Daikos

Publications and source records attributed to G K Daikos.

At least 37 records · Page 2Linked to original sources
PubMed1982

Ornidazole versus clindamycin: comparative evaluation in the treatment of 140 serious anaerobic infections.

A randomised prospective clinico-laboratory evaluation of the efficacy of ornidazole versus clindamycin in anaerobic infections was performed in 140 patients; 67 were given ornidazole and 73 received clindamycin. Patients were mainly suffering from peritonitis, pelvic cellulitis, endometritis, soft tissue infections and abdominal abscesses, which were distributed rather equally in both groups. Ornidazole was administered at a dose of 500 mg every 12 h i.v. or/and orally, and clindamycin 600 mg every 8 h i.v. for 7-60 days. In pus cultures, Escherichia coli and Bacteroides fragilis were the main isolates. The coexistence of aerobes necessitated the addition of an aminoglycoside in 111 patients, while six times chloramphenicol had proved ineffective against anaerobes. Between the two groups no statistically significant difference was found in the excellent response rate, although the overall cure rate was superior in the ornidazole group (80.6 vs. 68.5%), with a prompt response within less than 48 h in the case of ornidazole. Side effects necessitating discontinuation of chemotherapy included severe nausea in 1 patient treated with ornidazole and diarrhea in 8 patients given clindamycin.

Adolescent↗
PubMed1981

Antibacterial activity of Ro 13-9904 and preliminary experience in gonorrhoea and chronic urinary tract infections.

Ro 13-9904, a new broad-spectrum, beta-lactamase-resistant, cephalosporin, was given as a single i.m. injection at doses of 500, 250, and 125 mg in 3 groups of male patients each consisting of 10, 6, and 6 patients respectively, suffering from uncomplicated acute but recurrent gonococcal urethritis. All patients were cured both clinically and bacteriologically without relapsing after a 7-day follow-up. 11 patients suffering from chronic urinary tract infections without flow obstruction but with underlying chronic pyelonephritis in 6, were treated for 7 days with 500 mg of Ro 13-9904 i.m., every 12 h. E. coli and P. mirabilis were the main isolated pathogens. Treatment was successful in all with only one bacteriological relapse during the follow-up period. The drug's tolerance was satisfactory except for moderate local pain in most of the patients.

Adult↗
PubMed1979

Prospective comparative evaluation of gentamicin or gentamicin plus cephalothin in the production of nephrotoxicity in man.

Recent studies in animal models have demonstrated that in contrast with humans, cephalothin (CTIN) does not increase gentamicin (GENT) nephrotoxicity, but rather protects against it, particularly when CTIN is given simultaneously with GENT. To investigate this phenomenon in humans a study was designed in which 67 patients suffering from mild infections were investigated. Thirty-three of them served as the control group receiving GENT alone at a dose of 1.5 mg/kg/8 hourly, while the remaining 34 received CTIN at a dose of 2 g or 3 g 8 hourly by i.v. bolus, either simultaneously with GENT or separated by a 4-h interval. Findings showed that: (a) cylindruria developed in 66.6% and 82.3% and 82.3% in the GENT and GENT + CTIN groups respectively, (b) urinary beta-glycuronidase activity increased in 57.5% and 75% (c) serum creatinine exceeded by 0.3 mg the initial values in 21.2% and 27.6% and (d) the blood urea was above 50 mg% in 18.1% and 17.6% of the patients. These results indicate that: (a) regardless of the route and order of administration simultaneous treatment did not protect against nephrotoxicity in humans; (b) the combination of GENTA plus CTIN has no synergistic effect on the production of elevated serum creatinine and rising blood urea; (c) urinary beta-glycuronidase is not a significant predictor of eventual nephrotoxicity; (d) the following risk factors influenced the appearance of nephrotoxicity in both groups: (1) elevated GENT trough levels greater than or equal to 2 mg/l; (2) a course of treatment longer than 10 days.

Adult↗
PubMed1979

Pseudomonas infections of the lung treated with azlocillin. Microbiology, pharmacokinetics, clinic.

6-[(R)-2-(2-Oxo-imidazolidine-1-carboxamido)-2-phenyl-acetamido]-penicillanic acid sodium salt (azlocillin, Securopen), has a special activity against Pseudomonas species besides is broadspectrum character. We confirmed the high in vitro potency of that antibiotic in 200 clinical Pseudomonas isolates. Good penetration of azlocillin into bronchial secretions was found, especially through the inflamed bronchial mucosa, but also in the post-inflammatory phase. In 16 patients with serious Pseudomonas infections of the respiratory tract the good efficacy of azlocillin was shown. There were no tolerance problems.

Azlocillin↗
PubMed1979

Elimination kinetics of mezlocillin in normal and impaired renal function including the effects of dialysis.

The kinetics of 6-[(R)-2-[3-methylsulfonyl-2-oxo-imidazolidine-1-carboxamido]-2-phenyl-acetamido]-penicillanic acid sodium salt (mezlocillin, Baypen) in renal failure were studied in 23 patients, given 5 g as i.v. infusion. Serum half-lives (t1/2) were around 60 min in normal renal function, 90 to 120 min in patients with a creatinine clearance (Clcr) of 30-60 ml/min, 160 to 190 min at a ClCr of 15 to 30 ml/min and 6 to 14 h in patients with a ClCr below 10 ml/min. There was a linear correlation between serum creatinine and t1/2. Peritoneal dialysis reduced t1/2 to 3 to 4 h and during haemodialysis t1/2 was 1.4 to 2 h with a mean extraction ratio of 0.25. Levels in urine were very high, even in advanced renal failure and the recovery rate was around 60% of dose in normal renal function, but less in renal failure, being only 10-20% at a ClCr of less than 10 ml/min. Levels in peritoneal dialysate fluctuated between 20 and 30 microgram/ml for 4 to 6 h after the infusion, falling slowly but still averaging 10 to 15 microgram/ml after 18 h. Dosage regimens are proposed for various situations in impaired renal function.

Half-Life↗
PubMed1976

Amikacin in treatment of infections caused by gram-negative bacteria resistant to gentamicin and other aminoglycosides: clinical and bacteriologic results.

Amikacin (250 or 500 mg) was administered intramuscularly twice daily at 12-hr intervals to 34 patients with infections due to various gram-negative bacteria. Usually one or more aggravating factors were present, such as serious underlying pathology or therapy with steroids or immunosuppressants. Clinical isolates from most patients were resistant to gentamicin and other aminoglycosides. The overall response to therapy was excellent in 20 patients; in eight patients clinical response was good, but the organism persisted. Six patients showed some improvement without complete resolution of the infection or eradication of the causative organism. There were no complete clinical or bacteriologic failures. Ototoxicity was not observed in any patient. Levels of blood urea nitrogen and serum creatinine increased in two patients but returned to pretreatment levels within two weeks after therapy. No other adverse reactions were noted. Amikacin may replace gentamicin as initial therapy in serious gram-negative bacillary infections, particularly when resistance to gentamicin is a problem.

Adolescent↗