Search PubMed⌕ Search

Biomedical subjects

R Lüthy

Publications and source records attributed to R Lüthy.

At least 199 records · Page 11Linked to original sources
PubMed1982

[Multicenter study on the status of antibiotic and chemotherapy resistance in Switzerland 1979].

In 1979 a three-month multicentre study of resistance of bacteria isolated from humans and animals was carried out in Switzerland with the participation of 22 institutes and laboratories. A total of 23,852 antibiograms were evaluated concerning the following bacteria: Escherichia coi, Klebsiella pneumoniae, Salmonella sp., Serratia marcescens, Proteus (indole-negative), Proteus (indole-positive), Pseudomonas aeruginosa, Staphylococcus aureus, and enterococci (streptococci of Group D). 95.5% of the strains were isolated from human material, almost half being isolated from urine. The remaining 4.5% were obtained from animal material, more than half being isolated from the milk of cows with mastitis. Although the various institutes and laboratories did not use a uniform, standardized method, the results are closely in line with those of similar studies carried out earlier in Switzerland, Germany, Austria and the USA. No pronounced trend in the direction of increased resistance is observable.

Animals↗
PubMed1982

[Selection of antibiotics and practice and the clinic].

The multiplicity of antibiotics currently available for the treatment of bacterial infections in outpatients and inpatients has led to considerable confusion and uncertainty in recent years. An attempt is made to establish indications for the use of the various groups of antibiotics, paying due regard to cost as well as other aspects. This means drawing a distinction between the respective needs of out- and inpatients. In treating outpatients, where resistance is less of a problem than in hospitals, use is made principally of oral substances. In the light of current knowledge the vast majority of bacterial infections occurring in ambulatory practice can be optimally treated with pyrimidine-sulfonamide combinations, penicillins, tetracyclines and erythromycin. In contrast, the range of broad-spectrum antibiotics administered in hospitals, for the most part parenterally, in infections of a life-threatening nature or due to organisms exhibiting multiple resistance, is quite different. Most important are the more recent penicillins and cephalosporins and the aminoglycosides. By combining betalactam antibiotics with aminoglycosides and attempt is made to extend the therapeutic spectrum and intensify antibacterial activity. A conclusive judgement on the therapeutic differences between the more recent penicillins and cephalosporins as single-substance therapy or in combination with aminoglycosides is not yet possible at present. There seems good reason, however, to combine the more recent penicillins with aminoglycosides in infections in which enterococci, pseudomonas and anaerobic bacteria are also involved. In infections in which there is a possibility of Klebsiella involvement or in which penicillin allergy or penicillin resistance is present, treatment tends to be a combination of cephalosporins and aminoglycosides.

Aminoglycosides↗
PubMed1982

Erythromycin (2 X 1 g) as a Regimen for community-acquired pneumonia.

Erythromycin is regarded more and more as the primary therapy for community-acquired pneumonia. In a prospective study, treatment with erythromycin was evaluated in cases of community-acquired pneumonia requiring hospitalisation. Therapy was started intravenously with 1 g erythromycin lactobionate b. i. d., followed by 1 g erythromycin ethylsuccinate b. i. d., administered orally, until the patient had definitely recovered. Twenty-four patients with documented pneumonia were admitted to the study; five were excluded since the infections were caused by bacteria which were not susceptible to erythromycin. Nineteen patients responded well to therapy. No severe side-effects could be observed. Erythromycin (1 g b. i. d.) appears to be an effective, well-tolerated regimen for severe community-acquired pneumonia.

Erythromycin↗
PubMed1981

[Assessment of aminoglycoside serum concentrations. Comparative study using gentamicin (author's transl)].

Four methods were used to assess gentamicin concentrations in 37 sera of patients treated with gentamicin. It was shown that the bioassay (agar diffusion) and the enzyme immunoassay correlated well, and the latex agglutination inhibition test badly, with the radioenzyme assay which was used as the reference method. Among presently available methods only the bioassay can be performed with relatively little equipment.

Gentamicins↗
PubMed1981

[Lactobacillus casei endocarditis after aortic valve prosthesis].

A report is presented on a 53-year-old patient with endocarditis caused by Lactobacillus casei 9 years after prosthetic replacement of the aortic valve with a Björk-Shiley graft. In spite of a delay of about 6 weeks before therapy was started (due to difficulties in identifying the causative agent), treatment with a combination of penicillin G and gentamicin was effective and replacement of the artificial valve was not necessary. Seven months after cessation of therapy the patient is still free of symptoms. No other report of conservatively managed endocarditis due to lactobacilli and involving a prosthetic valve was found in the literature accessible to our group.

Anticoagulants↗
PubMed1981

[Mild spontaneous course of a case of pseudomembranous colitis. Case report and literature review].

Pseudomembranous colitis (PMC) caused by a toxin produced by Clostridium difficile is described in the literature as a severe diarrheal disease with a high mortality rate. A case which tends to absolve PMC from this reputation is reported involving an outpatient who developed well documented PMC subsequent to ampicillin therapy but required no treatment. The number of unreported cases of antibiotic-associated colitis with and without pseudomembrane formation is probably very high, since only severe cases of diarrhea are thoroughly investigated. In a chronological literature review an attempt is made to update the nomenclature of antibiotic-associated colitis. There are recent reports of a connection between the Clostridium difficile toxin and the chronic inflammatory "non-bacterial" intestinal diseases ulcerative colitis and Crohn's disease. The authors finally consider whether in cases of antibiotic-associated diarrhea efforts should be made to isolate Clostridium difficile and/or demonstrate the presence of its toxin, for the purposes of prognosis and therapy.

Ampicillin↗
PubMed1981

[Use of antibiotics in ambulatory care. Results and reflections on a survey of practicing physicians in the canton of Zurich].

To survey antibiotic use in general practice, questionnaires were sent to 1160 practitioners in the Canton of Zurich. 510 (44%) were returned. Antibiotics had been administered for respiratory tract infections in 60% and urinary tract infections in 20% of cases. Sulfamethoxazole/trimethoprim, followed by oral penicillin, tetracycline and aminopenicillin were prescribed most frequently. Adverse side effects do not appear to be significant in general practice. Guidelines for the diagnosis and treatment of the most frequent infectious diseases occurring in an outpatient population are presented.

Ambulatory Care↗
PubMed1981

Comparative multiple-dose pharmacokinetics of cefotaxime, moxalactam, and ceftazidime.

The pharmacokinetics of cefotaxime, moxalactam, and ceftazidime were investigated in six human volunteers who received in a crossover fashion doses of 0.5, 1.0, and 2.0 g of each drug by a 5-min infusion. Doses of 1.0 g were repeated after the administration of probenecid. Serum and urine concentrations were assayed with an agar diffusion method. Serum concentrations of moxalactam exceeded those of ceftazidime at all times and were distinctly higher than those of cefotaxime. The normalized area under the concentration time curve (defined as the ratio of the area under the curve per dose) reflects this relationship: compared with cefotaxime the normalized area under the curve of moxalactam was 3 to 4 times higher, and that of ceftazidime was 2 to 3 times higher. By intra-individual comparisons, the area under the curve of moxalactam was 44% larger than that of ceftazidime. With increasing doses, cefotaxime exhibited a nonlinear increase of the area under the curve. The half-lives of moxalactam, ceftazidime, and cefotaxime were 2.34, 1.95, and 1.16 h, respectively. The volume of distribution averaged 0.20 +/- 0.03, 0.23 +/- 0.02, and 0.25 +/- 0.04 liters per kg, and the mean total body clearance was 84, 131, and 328 ml/min for moxalactam, ceftazidime, and cefotaxime, respectively. The 24-h urinary recovery was highest for moxalactam (75 +/- 4%) followed by ceftazidime (68 +/- 11%) and cefotaxime (53 +/- 6%). The influence of probenecid on serum concentrations, half-life, area under the curve, and clearance was most apparent with cefotaxime, whereas the pharmacokinetics of moxalactam and ceftazidime were only slightly affected. After the 0.5- and 2.0- g doses of cefotaxime, desacetyl-cefotaxime activity (determined by high-pressure liquid chromatography) reached a peak of 2.7 and 9.9 mug/ml and declined with a half-life of 1.9 and 1.4 h. The ratio of the R(-) and S(-) epimers of moxalactam, which could be differentiated by high-pressure liquid chromatography, fell rapidly from 0.81 at 0.17 h to 0.5 at 5 h, indicating the presence of twice as much of the microbiologically less active S(-) epimer. From a pharmacokinetic standpoint it appears reasonable to conclude that moxalactam and possibly ceftazidime could be administered twice daily and that cefotaxime could be administered three or even four times daily.

Cefotaxime↗
PubMed1980

[Oxidative metabolism of phagocytes: physicochemical events and clinical relevance (author's transl)].

The microbicidal activity of phagocytes is primarily dependent upon two intracellular processes: degranulation and respiratory burst. The latter one is associated with a partial reduction of molecular oxygen leading to the production of highly reactive oxydizing agents with microbicidal activity. Since an efficiant intracellular antimicrobial function of phagocytes is mainly based on the intracellular process of fusion of lysosomes with the phagocytic vesicles and the production of highly reactive oxygen radicales, disturbances of both these events will cause increased susceptibility against microorganisms and in most of the cases severe infections.

Chemical Phenomena↗
PubMed1980

[Therapy of anaerobic infections].

The treatment of anaerobic infections still poses various problems for the physician. The authors deal with the surgical, but also, and in particular, the antibiotic treatment of anaerobic infections. The in-vitro activities, indications, side effects and dosage recommendations of the first choice (clindamycin, metronidazole and ornidazole, cefoxitin, penicillin G) and second choice antibiotics (chloramphenicol, ticarcillin) are discussed.

Abscess↗
PubMed1980

[Incidence of bacteremia in heart catheterization: results of a prospective study on the prevention of endocarditis with cefazoline versus placebo].

145 consecutive patients scheduled for a cardiac catheterization were enrolled in a prospective double-blind randomized study to determine the incidence of bacteremia during and following catheterization and the usefulness of antibiotic prophylaxis with cefazolin versus placebo during this procedure. Four blood cultures were taken from each patient to evaluate the incidence of bacteremia vs. contamination. 15 of 296 (5.07%) and 11 of 284 (3.8%) cultures yielded bacteria in the placebo group (74 patients) and in the cefazolin-group (71 patients) respectively. Statistical analysis revealed no significant difference between the groups. These results, together with the spectrum of the organisms isolated and the clinical and laboratory findings, suggest that the isolation of bacteria was due rather to contamination than the result of bacteremia. It is concluded that antibiotic prophylaxis in patients undergoing cardiac catheterization is unnecessary and not indicated.

Blood↗
PubMed1980

Basis for an adequate dosage of aminoglycoside antibiotics.

Findings in clinical and microbiological investigations indicate that aminoglycoside therapy should be monitored by means of serum concentration assays for the following three reasons: 1) In vitro and in vivo studies indicate a quantitative relationship between aminoglycoside blood concentrations and clinical efficacy. 2) In contrast, attained serum concentrations correlate only poorly with the administered dose. 3) Nephrotoxicity and ototoxicity appear to be correlated with the area under the serum concentration time curve. Each of these arguments is illustrated with microbiological, pharmacokinetic or clinical studies. Presently available computer-based dosage recommendations inadequately take into account the individual variability of the patient.

Amikacin↗