Search PubMed⌕ Search

Biomedical subjects

J Klastersky

Publications and source records attributed to J Klastersky.

At least 289 records · Page 16Linked to original sources
PubMed1981

Anti-Pseudomonas activity in bronchial secretions of patients receiving amikacin or tobramycin as a continuous infusion.

The penetration of amikacin and tobramycin into bronchial secretions and the resulting anti-Pseudomonas activity were assessed in two groups of tracheostomized or intubated patients with tracheobronchial infection and purulent bronchial secretions. The aminoglycosides were administered as continuous, high-dose intravenous infusions. The mean drug concentrations in serum and bronchial secretions were 12.8 and 2.0 microgram/ml for amikacin and 3.6 and 0.7 microgram/ml for tobramycin. The bronchial secretion/serum ratios varied over a wide range: from 9.6 to 22.8% (average, 14.9%) for amikacin and from 3 to 39.3% (average, 17.5%) for tobramycin. Sustained anti-Pseudomonas activities in bronchial secretions were achieved only in patients with very high aminoglycoside levels in serum. In most patients, however, no anti-Pseudomonas activity could be detected within bronchial secretions despite therapeutic levels of amikacin and tobramycin and adequate bactericidal activities in serum.

Amikacin↗
PubMed1981

Effect of mixing on rifampin bactericidal activity against staphylococci.

Minimal bactericidal concentrations of rifampin were significantly increased, and serum bactericidal activity from volunteers receiving this drug was significantly decreased by vigorous mixing of microtiter plates before sampling when tested against Staphylococcus aureus and Staphylococcus epidermidis at 10(5) and 10(6) colony-forming units per ml. These results suggest that microtiter estimates of the bactericidal activity of rifampin against staphylococci should be performed after vigorous shaking.

Anti-Bacterial Agents↗
PubMed1981

In vitro and in vivo studies of three antibiotic combinations against gram-negative bacteria and Staphylococcus aureus.

The activities of azlocillin, cefotaxime, and amikacin alone and in combination were evaluated in in vitro checkerboard studies, in infected neutropenic mice, and in human volunteers. The combination of cefotaxime plus amikacin was more synergistic in vitro than the others against the Enterobacteriaceae tested, and the combination of azlocillin plus amikacin was more synergistic against Pseudomonas aeruginosa and Staphylococcus aureus. Survival of neutropenic mice infected with Escherichia coli and Klebsiella pneumoniae, respectively, was greater with azlocillin plus amikacin (24 of 40 and 11 of 40) and with cefotaxime plus amikacin (21 of 40 and 17 of 40) than with azlocillin plus cefotaxime (22 of 40 and 3 of 40; P less than 0.05). Median serum bactericidal activity in volunteers receiving these antibiotics alone and in combination was greater than or equal to 1:8 with most agents and with all combinations tested against 10 strains each of E. coli, K. pneumoniae, P. aeruginosa, and S. aureus. These data suggest that clinical trials with combinations of azlocillin or cefotaxime plus amikacin deserve further study in febrile neutropenic patients.

Amikacin↗
PubMed1981

Serum bactericidal activity of moxalactam and cefotaxime with and without tobramycin against Pseudomonas aeruginosa and Staphylococcus aureus.

Serum bactericidal activity was determined against 10 strains each of Pseudomonas aeruginosa and Staphylococcus aureus in serum from volunteers 1 and 6 h after intravenous infusion of cefotaxime, tobramycin, and the combination; or of moxalactam, tobramycin, and the combination. High serum bactericidal activity against P. aeruginosa was found significantly more frequently with moxalactam plus tobramycin than with cefotaxime, moxalactam, and tobramycin alone or with cefotaxime plus tobramycin.

Anti-Bacterial Agents↗
PubMed1980

Prediction and significance of synergy between antibiotics used for treatment for gram-negative sepsis.

Clinical tests capable of predicting synergism between penicillins and aminoglycosides are discussed. The results obtained in these tests are correlated to those of in vitro tests. Lack of in vitro synergism was associated with very low bactericidal activity in the serum. In order to determine the serum cidal activity tube dilutions were carried out using serum of plasma obtained from a patient who had received the antibiotic or a combination of drugs at a specified time before venipuncture. Dilutions were made with a pool of plasma or serum. This method needs further standardisation. It has been shown that the bactericidal dilutions of sera in patients treated with synergistic combinations were usually adequate, i. e. sera were active at a 1:8 dilution, while sera of most patients who received non-synergistic combinations were not active at this dilution. The determination of the bactericidal activity of the serum is not only a useful tool for monitoring therapy, it can be used also as an investigational means for comparing the respective efficacy of antibiotics administered alone or in combination. The test is probably more meaningful clinically than the simple in vitro microbiological studies or the determination of blood levels. It integrates some pharmacological characteristics of the drugs studied and the sensitivity of the pathogen to these drugs.

Aminoglycosides↗
PubMed1980

Carbenicillin plus cefazolin with or without mecillinam as an early treatment of bacteremia caused by gram-negative organisms: randomized double-blind study.

Mecillinam or a placebo was added to a combination of cefazolin and carbenicillin as an early therapy of septicemia caused by gram-negative organisms in patients with serious underlying diseases, none of whom was neutropenic, however. Patients in whom infection was caused by pathogens against which mecillinam and cefazolin or mecillinam and carbenicillin were synergistic might have responded more often than patients treated with nonsynergistic combinations. However, overall results did not show any benefit from combining mecillinam with cefazolin and carbenicillin. This study suggests that in nonneutropenic patients with septicemia caused by gram-negative organisms, there is no need to intensify antimicrobial therapy beyond a certain point of efficacy. The measurement of the bactericidal activity in the serum of treated patients might serve as guide for adequate therapy.

Amdinocillin↗
PubMed1980

High-dose cisplatin with fluid and mannitol-induced diuresis in advanced lung cancer: a phase II clinical trial of the EORTC Lung Cancer Working Party (Belgium).

A phase II clinical trial of high-dose cisplatin (120 mg/m2 iv every 3 weeks), with fluid and mannitol-induced diuresis, was conducted in 81 patients with advanced lung cancer. Partial remissions were documented in 26% of 75 evaluable cases for a median duration of 3.5 months. Adenocarcinoma and small cell anaplastic carcinoma were more responsive than epidermoid carcinoma, with partial response rates of 35%, 30%, and 18%, respectively. The median survival of responders (8.5 months) was significantly longer than the survival of nonresponders (4 months) (P less than 0.02). Myelosuppression was mild. Renal toxicity with peak serum creatinine greater than 2.5 mg/100 ml occurred in eight patients, with one death occurring due to toxicity. Cisplatin is an active drug in advanced lung cancer.

Adenocarcinoma↗