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Biomedical subjects

K Naber

Publications and source records attributed to K Naber.

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

[Clinical significance of bacterial beta-lactamase production in the treatment of urinary tract infections with oral beta-lactam-antibiotics].

In 649 urological patients with urinary tract infections (UTI) a total of 1114 bacterial strains were isolated and their beta-lactamase production was investigated by a qualitative, micro-iodometric method. Approximately 40% of all strains, 33% of E. coli species and 8% of Proteus mirabilis species were enzyme producers. All of the isolates of E. coli and Proteus mirabilis defined as non-producers were sensitive to ampicillin and cephalothin in the agar diffusion test. The beta-lactamase producers of these two species did not show the same pattern: almost all of them were ampicillin-resistant, but most were cephalothin-sensitive. The other species were all found to be either producers or non-producers. Therapeutic comparisons in altogether 138 UTI patients treated with ampicillin or cephalexin, two antibiotics with different beta-lactamase stability, confirmed the positive correlation between enzyme production and therapeutic failure in both groups. Cephalexin, however, tended to be more effective than ampicillin against enzyme-producing species.

Administration, Oral↗
PubMed1982

[Renal kinetics of contrast media in unilateral diseased kidney (author's transl)].

In order to utilize excretory urography for urological diagnosis as optimal as possible renal physiology and pathophysiology as well as urodynamics have to be fully considered. Experimental and clinical data of various degrees of bilateral renal insufficiency, unilateral renal impairment and unilateral hydronephrosis were used to compute plasma and urinary concentrations of contrast media in the diseased and contralateral kidney. The results can be summarized as follows: 1. In bilateral renal insufficiency without hydronephrosis delayed exposures do not improve the diagnostic findings. Increased administration of contrast media increases naturally the urinary concentration.--2. In unilateral renal impairment only high degrees of impairment are of clinical significance. The excretory urography therefore is not suitable for split function tests. In high degrees of impairment diagnostic results can be improved by delayed exposures up to 6 hours.--3. In general, delayed exposures improve the diagnostic results in hydronephrosis. In chronic hydronephrosis with high degrees of renal impairment the obstruction often can still be localized by use of continuous infusion urography. This investigation method is tolerated well, if the contraindications of highly osmotic substances and high fluid intake are considered.

Contrast Media↗
PubMed1981

Pharmacokinetics of co-trimoxazole and co-tetroxazine in geriatric patients.

Following a single dose of co-trimoxazole or co-tetroxazine, the plasma and urine levels of intact trimethoprim (TMP) and sulphamethoxazole (SMZ) and of tetroxoprim and sulphadiazine (SDZ) were determined in six geriatric patients in a cross-over design by high pressure liquid chromatography. The pharmacokinetic analysis showed a plasma elimination half-life in the terminal phase of 10.39 h for TMP, 11.79 h for SMZ, 6.55 h for TXP and 10.46 h for SDZ. The resulting distribution volumes Vd beta and total plasma clearance values corresponded with the data obtained in young patients or volunteers. Recovery in urine, measured for up to 96 h, was 49.2% (TMP), 19.8% (SMZ), 57.03% (TXP) and 61.1% (SDZ). In contrast to young volunteers, geriatric patients experienced a slight prolongation of renal excretion for both sulphonamides. In this group of patients the renal clearance was 2.42 ml/min for SMZ and 10.7 ml/min for SDZ.

Absorption↗
PubMed1980

[Pharmacokinetics of cefotaxim in geriatric patients (author's transl)].

The behavior of plasma concentrations after intravenous and intramuscular administration of 2 g cefotaxim (Claforan) was determined in an intra-individual cross-over comparison in 10 geriatric patients. The half-lives measured of about 2 hours were approximately twice as long as in healthy subjects. Thus an effective level is maintained over the same period with half the recommended dose of antibiotic compared with younger patients, which could be clinically relevant.

Aged↗
PubMed1979

[Comparative study of cefaclor versus amoxicillin in urinary tract infections (author's transl)].

In a comparative, prospective, open randomised clinical study, the efficacy and tolerance of cefaclor (3 x 500 mg) and amoxicillin (3 x 750 mg) in the treatment of urinary tract infection (UTI) were investigated and compared. A total of 110 patients (51 males and 59 females) age 10 to 83 years were treated for a period of five to 14 days (average 10 days). Fifty-nine of the patients had complicated, and 51 uncomplicated UTI. In all patients , organisms were cultured from the urine which were sensitive to both antibiotics in vitro. In each group there were three cases of mixed infection and 35 cases of Escherichia coli monoinfection. The distribution of pathogens in the other patients was likewise very similar. Better results, i.e. a reduction in the cell count to < 10(4)/ml immediately after completion of therapy, were obtained in patients treated with cefaclor. This is largely due to a statistically significantly higher rate of elimination in E. coli infections. The long-term results at follow-up examinations 14 to 60 days after completion of therapy in both groups with uncomplicated infections were, however, equally as good in about half the cases. In complicated infections therapy was successful overall in only about a quarter of the cases, better results being obtained in the amoxicillin group. It must be taken into account that among the patients treated, the groups with complicated UTI are difficult to compare, relapses primarily being determined by underlying disease. Both antibiotics were tolerated well.

Adolescent↗
PubMed1976

Pharmacokinetics of sisomicin in patients with normal and impaired renal function; its efficacy in urinary tract infection.

Serum concentration, biological half-life, distribution space and serum clearance of sisomicin, a new aminoglycoside antibiotic, have been studied in twenty-three patients in comparison with the pharmacokinetics of 125I-labelled iothalamate, a compound only filtered by the kidney. 10 patients had normal or borderline abnormal serum creatinine (less than 1,5 mg/100 ml), 8 had various degrees of renal insufficiency (serum creatinine 1.7-9.6 mg/100 ml) and 6 were being treated by intermittent haemodialysis. After intravenous injection of sisomicin 1 mg/kg body weight in patients with normal or borderline renal function its half-life was 3.5 h, very similar to that of iothalamate, 3.2 h. The mean distribution space was 20.1% per cent of body weight; iothalamate, 23.7%. In patients with renal insufficiency there was a positive correlation between serum creatinine level and the half-life of sisomicin, and an even stronger correlation between the clearances of iothalamate and sisomicin. In patients dependent on haemodialysis, the mean serum half-life between dialysis was 40 h, compared to approximately 100 hours for iothalamate, which implies additional extrarenal clearance or tubular secretion of sisomicin. The results of pharmacokinetic studies indicated that a regime of sisomicin 1 mg/kg every 8 to 12 hours in patients with normal renal function would result in serum and urine levels sufficiently high to treat most urinary tract infections. In patients with impaired renal function the dosage interval should be increased according to the serum creatinine level, and in patients dependent on haemodialysis one standard dose at the end of each dialysis period should suffice. 9 patients with a chronic urinary tract infection severely complicated by an underlying disease were treated according to this dosage regimen with a satisfactory bacteriological and clinical result. No adverse reactions or signs of accumulation were observed.

Adult↗