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Biomedical subjects

G Kahlmeter

Publications and source records attributed to G Kahlmeter.

At least 55 records · Page 3Linked to original sources
PubMed1983

Chlorhexidine for prevention of neonatal colonization with group B streptococci. I. In vitro effect of chlorhexidine on group B streptococci.

Forty-three strains of group B streptococci (GBS) of types Ia, Ib, II and III were tested for susceptibility to chlorhexidine in concentrations ranging from 256 to 0.25 mg/l using the agar and tube dilution methods. The strains showed minimum inhibitory concentration (MIC) values ranging from 0.5 to 1 mg/l. Serum added to the test medium (50%) increased the MIC values to 4-8 mg/l, while amniotic fluid (50%) had almost no effect, increasing the values to 1-2 mg/l. The minimum bactericidal concentration (MBC) ranged from 1 to 5 mg/l. The killing kinetics were related to the concentration of chlorhexidine and the length of exposure. For example, at a concentration of 63 mg/l, 7 h were required for a bactericidal effect in broth, as compared to 1 h at 500 mg/l chlorhexidine. 200 mg/l chlordexidine had no effect on the adherence of two GBS strains to vaginal epithelial cells, and no effect on the phagocytosis of GBS with mouse peritoneal macrophages.

Bacteriolysis↗
PubMed1983

Chlorhexidine for prevention of neonatal colonization with group B streptococci. II. Chlorhexidine concentrations and recovery of group B streptococci following vaginal washing in pregnant women.

The effect of a single washing of the urogenital tract with 0.5 g/l chlorhexidine was studied in 6 women in weeks 38-40 of pregnancy, among whom 5 were carriers of group B streptococci in urethra and/or cervix. The chlorhexidine concentrations varied between 25 and 200 mg/l during the first hour after washing in 5 of the 6 women, whereas one patient showed concentrations below 25 mg/l. With the exception of one patient, all individuals showed concentrations less than 25 mg/l at 3-24 h after washing. A clear suppression of the number of colony-forming units of GBS was already apparent after 60 min and was still evident 6 h after chlorhexidine washing.

Carrier State↗
PubMed1983

Total hip joint arthroplasty with gentamicin-impregnated cement. A clinical study of gentamicin excretion kinetics.

The excretion pharmacokinetics of gentamicin (GM) following total hip joint arthroplasty with GM-impregnated bone cement were studied in ten patients. The patients received 0.5-1.1 g of GM. Twenty-four-hour portions of urine were collected for up to 60 days after operation. GM concentrations in urine were initially 8-25 mg/l, and during the first four days the excretion ranged from 0.7 to 25 mg/day. On the 30th day drug levels in the urine were 0.5-1.0 mg/l, and the excretion was 0.5-1.0 mg/day. The GM excretion-time curve consisted of an initial rapid phase that terminated four to six days after operation, with a half-life of 0.65 days, and a slow phase with a half-life of 7.5-73.0 days (mean, 16 days). From the area under the excretion-time curve and from extrapolation of the registered terminal phase, it was calculated that 5%-18% (mean, 13%) of the GM administered was accounted for. Thus, a major portion of the drug was unaccounted for. Data obtained two years after operation suggested that the half-life of the terminal phase is much longer (greater than 240 days) than that calculated from data obtained during the first two months after operation. It was calculated that the surface area of the cement would be in excess of 150 cm2 and that the volume of an interface tissue layer 1 mm thick would be approximately 15 cm3. Thus, at three weeks, when the daily excretion was approximately 1 mg/24 hours, 67 micrograms/cm3/day of GM would be available for antimicrobial action at a tissue--cement interface 1 mm thick.

Adult↗
PubMed1980

Mecillinam and ampicillin separately or combined in gram-negative septicemia.

Of 20 patients with gram-negative septicemia treated with mecillinam alone or in combination with ampicillin, successful therapeutic results were obtained in 16. In 11 patients treated with ampicillin alone, three failures responded successfully to a combination of mecillinam and ampicillin. Mecillinam MIC values of isolated Enterobacteriaceae were 0.05-0.4 micrograms/ml. In patients receiving 5 mg/kg mecillinam intravenously every six hours, the mean 0.5 hour concentration was 11.0 micrograms/ml and in those given 10 mg/kg 23.3 migcrograms/ml. No serious side effects were recorded. One patient on mecillinam developed an exanthema, as did three patients on combined therapy.

Adult↗
PubMed1980

Dicloxacillin and flucloxacillin twice daily with probenecid in staphylococcal infections. A clinical and pharmakokinetic evaluation.

The therapeutic efficacy of decloxacillin or flucloxacillin, 1--2 g orally with probenecid twice daily was evaluated in staphylococcal infections. Excellent results were obtained with this as long-term maintenance therapy in 4 patients with relapsing chronic osteomyelitis and in 6 patients with postoperative infections. No side effects were observed in these patients. In 35 patients with furunculosis twice daily administration of dicloxacillin was used as a primary therapeutic regimen. All healed, but 4 recurrencies occurred during a 3-month observation period after therapy. In 5 patients allergic reactions were noted. The unbound fraction of flucloxallin in serum exceeded MIC values of methicillin-susceptible Staphylococcus aureus during 11 of 24 h. Pharmacokinetic data on flucloxallin with and without probenecid are given.

Cloxacillin↗
PubMed1979

Evaluation of spiramycin in meningococcal carriage.

Spiramycin was administered to healthy carriers of meningococci in doses of 1.5 g twice daily or 2.5 g once daily for 3 days, or 1.5 g once daily for 10 days. Meningococci were eliminated from the nasopharynx and throat in approximately 50% of the carriers with all dose schedules. In the remaining carriers only a temporary suppression of the strain was achieved. Elimination occurred only in carriers where spiramycin saliva concentrations reached or surpassed the MIC value of respective strain for 42 h or more. Evidence of reinfection from close contacts was not obtained. Due to side effects the dose of spiramycin could not be increased. Further trials with spiramycin as the sole agent for eliminating meningococci in carriers do not seem warranted.

Adult↗
PubMed1978

Evaluation of spiramycin as a therapeutic agent for elimination of nasopharyngeal pathogens. Possible use of spiramycin for middle ear infections and for gonococcal and meningococcal nasopharyngeal carriage.

Varying doses of spiramycin were administered orally to healthy volunteers, and concentrations in serum and saliva were determined. The absorption of the drug was not significantly influenced by concomitant food intake. Saliva peak concentrations were 1.3--4.8 times higher than peak concentrations in serum. The elimination half life was 2--3 h in serum, and 4--8 h in saliva. Accumulation of the drug was seen in saliva but not in serum. The possible effect of spiramycin in eliminating bacteria from the nasopharynx was evaluated in vitro by comparing the spiramycin saliva concentrations with the MICs of bacteria known to establish themselves in the nasopharynx. At a concentration of 1.2 microgram/ml, spiramycin inhibited all investigated strains of group A streptococci, pneumococci and Branhamella catarrhalis, and at 2.4 microgram/ml all investigated gonococci. Concentrations of 19 and 38 microgram/ml, respectively, were required to inhibit all meningococci and Haemophilus influenzae. Following administration of 1.5 g spiramycin as a single daily dose for 3 days, the mean concentration in saliva reached or surpassed the MIC values of streptococci, pneumococci and Branhamella for 45 h, and of gonococci for 25 h. The possible use of spiramycin for prevention of relapses in acute otitis media and in treatment of serous otitis media is discussed, as well as the possible use of the drug in gonococcal and meningococcal nasopharyngeal carriage.

Acute Disease↗
PubMed1978

Tobramycin in patients with various infections: a clinical evaluation.

22 patients with various gram-negative infections were treated with tobramycin at a dose of approximately 3 mh/kg body weight/24 h for 7 to 53 (mean 16) days. Therapy was monitored with determinations of drug serum concentrations and renal and audio-vestibular function tests. In 16 patients either cure of clinical improvement were achieved. Two patients did not improve. In another 4 patients the effect of tobramycin therapy could nto be evaluated. One patient exhibited a subclinical vestibular dysfunction and one patient experienced transient tinnitus. In one patient, slight but clinically significant renal impairment occurred.

Adolescent↗