Search PubMed⌕ Search

Biomedical subjects

S S Pedersen

Publications and source records attributed to S S Pedersen.

At least 73 records · Page 4Linked to original sources
PubMed1988

Comparison of amoxycillin/clavulanate with amoxycillin in children and adults with chronic obstructive pulmonary disease and infection with Haemophilus influenzae.

71 children and adults (median age 7 years) with chronic obstructive pulmonary disease in which ampicillin-sensitive Haemophilus influenzae were isolated from lower airway secretions were included in a single-blind study comparing amoxycillin/clavulanate and amoxycillin alone. The dosage of amoxycillin was 50 mg/kg/day given together with probenecid and divided in 3 doses. Duration of treatment was 14 days. Clinical and bacteriological examinations were performed at study entry and again immediately after the treatment period. A late bacteriological follow-up 1.5 months after entry was performed. 65 patients were eligible for analysis of clinical outcome, and no difference between the groups was found. Side-effects were mild at a frequency of 3% for either preparation. In terms of eradication of the initially isolated H. influenzae amoxycillin/clavulanate tended to be better than amoxycillin, although the difference was not significant (70% and 57%, respectively). In a subset of 33 patients with polymicrobial flora amoxycillin/clavulanate was significantly more effective than amoxycillin. However, amoxycillin/clavulanate did not significantly reduce the emergency of beta-lactamase producing H. influenzae during treatment, and thus offers no advantage over amoxycillin in patients with amoxycillin-sensitive H. influenzae. The combination should be reserved to patients with either polymicrobial flora or ampicillin-resistant H. influenzae.

Adolescent↗
PubMed1987

Efficacy of oral fluoroquinolones versus conventional intravenous antipseudomonal chemotherapy in treatment of cystic fibrosis.

The clinical efficacy of the conventional aminoglycoside plus beta-lactam treatment was compared to that of monotherapy with oral quinolones in 26 adult cystic fibrosis patients in an open prospective clinical trial in which six two-week courses of antipseudomonas treatment were administered with an interval of approximately three months between treatments. In each patient two courses of conventional treatment were followed by two courses of quinolone treatment and then by another two courses of conventional treatment. The observed improvements in pulmonary function were somewhat higher when the patients received conventional treatments, and in the most seriously affected patients conventional treatment was significantly better than quinolone treatment. On the basis of these findings it is suggested that quinolone monotherapy cannot replace conventional antipseudomonal chemotherapy in patients with severe pulmonary involvement.

Adult↗
PubMed1987

Combined imipenem/cilastatin and tobramycin therapy of multiresistant Pseudomonas aeruginosa in cystic fibrosis.

Ten patients with cystic fibrosis (CF) and chronic broncho-pulmonary Pseudomonas aeruginosa infection were given imipenem/cilastatin (100 mg/kg/day) in combination with tobramycin (15 mg/kg/day). Forced vital capacity and forced expiratory volume in the first second improved significantly in nine out of ten patients, and most of the patients improved clinically. P. aeruginosa was not eradicated in any patient and resistance against imipenem developed in all patients during treatment. A concomitant increase in MIC of piperacillin and ceftazidime occurred during treatment. In-vitro bactericidal synergy of imipenem and tobramycin was noted in 57% of pretreatment isolates. Seven patients complained of adverse reactions, mainly gastrointestinal, and treatment of three patients was discontinued after 5, 8, and 12 days of therapy, because of rash or nausea and vomiting. The side effects were considered to be due to imipenem/cilastatin. Because of the rapid development of imipenem resistance despite combination therapy, the high proportion of side effects, and the risk of induction of beta-lactam resistance, imipenem/cilastatin cannot be recommended for routine treatment of CF-patients with P. aeruginosa infection.

Adolescent↗
PubMed1987

Colistin inhalation therapy in cystic fibrosis patients with chronic Pseudomonas aeruginosa lung infection.

Forty patients with cystic fibrosis and chronic broncho-pulmonary Pseudomonas aeruginosa infection entered a prospective double-blind placebo-controlled study of colistin inhalation. Active treatment consisted of inhalation of colistin one million units twice daily for three months and was compared to placebo inhalations of isotonic saline. Significantly more patients in the colistin inhalation group completed the study as compared to the placebo group (18 versus 11). Colistin treatment was superior to placebo treatment in terms of a significantly better clinical symptom score, maintenance of pulmonary function and inflammatory parameters. We recommend colistin inhalation therapy for cystic fibrosis patients with chronic P. aeruginosa lung infection as a supplementary treatment to frequent courses of intravenous anti-pseudomonas chemotherapy.

Administration, Inhalation↗
PubMed1987

Comparative pharmacokinetics of ciprofloxacin and ofloxacin in cystic fibrosis patients.

The steady state pharmacokinetic properties of ciprofloxacin and ofloxacin were compared in cystic fibrosis patients. In a cross-over study eighteen adult patients with chronic Pseudomonas aeruginosa lung infection were given either oral ciprofloxacin 750 mg bid or oral ofloxacin 400 mg bid for two weeks. Three months later the alternative treatment was given. Concentrations were determined by a microbiological assay. Mean serum concentrations of ofloxacin (peak 5.9 mg/l) were higher than for ciprofloxacin (peak 4.0 mg/l). The time to reach maximal concentrations did not differ. The apparent total body clearance was significantly greater for ciprofloxacin, but renal clearances were similar. Relative to ofloxacin ciprofloxacin had a significantly shorter serum elimination half-life (3.4 vs. 6.4 h), showed less penetration into sputum (18% vs. 79%) and a lesser amount was recovered in urine (21% vs. 71% up to 12 h after dosing). No correlation was found between any pharmacokinetic parameter and change in pulmonary function.

Adolescent↗
PubMed1987

The efficacy and safety of ciprofloxacin and ofloxacin in chronic Pseudomonas aeruginosa infection in cystic fibrosis.

The clinical efficacy and safety of ciprofloxacin and ofloxacin were compared in a prospective, randomized double blind, placebo combined cross-over study in 26 adult cystic fibrosis patients with chronic broncho-pulmonary Pseudomonas aeruginosa infection. Active treatment consisted of ciprofloxacin 750 mg orally twice daily or ofloxacin 400 mg orally twice daily; both treatments were given for 14 days, with three months between treatment periods; 21 patients completed both treatment periods. Treatment with both ciprofloxacin and ofloxacin was associated with a good clinical response as judged by clinical score, lung function tests and inflammatory parameters; no difference between ciprofloxacin and ofloxacin was found. Adverse reactions were seen in nine of 24 patients who received ciprofloxacin and in six of 23 who received ofloxacin. The majority were dyspeptic reactions or photosensitivity. No serious adverse reactions occurred. Three cases of treatment failure were found, one of which was associated with development of resistant P. aeruginosa during ofloxacin treatment. The mean MIC of both drugs increased during treatment but returned to pretreatment values within three months. Ciprofloxacin and ofloxacin seem to be valuable agents for intermittent treatment of chronic P. aeruginosa lung infection in adult cystic fibrosis patients.

Adolescent↗
PubMed1987

Management of Pseudomonas aeruginosa lung infection in Danish cystic fibrosis patients.

The annual mortality rate of cystic fibrosis patients with chronic Pseudomonas aeruginosa lung infection at the Danish CF-centre ranged from 10 to 20% in the years 1970-1975. In this period the patients received antipseudomonal chemotherapy only during acute exacerbations of infection. From 1976 99 patients acquired chronic P. aeruginosa infection and were given regular and intensive antipseudomonal treatment 3-4 times per year. The patients were followed for 612 patient-years; 7 died and the 10-year survival rate after onset of P. aeruginosa infection was 90% +/- 4%. The annual mortality rate is now 1-2%. Although precipitating antibodies against P. aeruginosa increased significantly, pulmonary function did not deteriorate with duration of infection. Cross-infection between patients caused an increased incidence of chronic P. aeruginosa infection which was reduced by hygienic measures.

Adolescent↗
PubMed1987

Cumulative and acute toxicity of repeated high-dose tobramycin treatment in cystic fibrosis.

Forty-six patients with cystic fibrosis and chronic bronchopulmonary Pseudomonas aeruginosa infection entered a study of tobramycin-related chronic and acute nephro- and acousticovestibular toxicity. The patients (mean age, 15.7 years) had previously received 2-week courses of tobramycin therapy, for a mean cumulative total of 279 days each. The cumulative tobramycin dose ranged from 632 to 7,644 mg/kg. The patients were studied before and at the end of a 2-week course of treatment with tobramycin (10 to 20 mg/kg per day) to discriminate between acute and chronic toxicity. In patients studied at the beginning of the present course of treatment, the glomerular filtration rate, measured as 24-h creatinine clearance, did not correlate with the cumulative dose of tobramycin received during previous courses. Eighteen patients (39%) had a reduced glomerular filtration rate compared with normal values (mean, 12.5% reduction) but normal serum creatinine values. Two patients (5%) had a high-frequency hearing deficit (above 8 kHz), but only one deficit was possibly related to tobramycin. No chronic vestibular toxicity was observed. During the course of treatment, no patients developed acute nephrotoxicity. After 2 weeks of treatment 32% had a slightly reduced hearing threshold (15 to 30 dB) in two or more high frequencies, and 28% had a fall in vestibular response greater than 25% of the initial value but remained within normal limits. Thus, the acute and chronic toxicity of repeated high-dose tobramycin treatment in cystic fibrosis patients seems to be very mild.

Adolescent↗
PubMed1987

Diagnosis of chronic Pseudomonas aeruginosa infection in cystic fibrosis by enzyme-linked immunosorbent assay.

An easily applicable test for diagnosis of chronic Pseudomonas aeruginosa infection in cystic fibrosis by enzyme-linked immunosorbent assay (ELISA) for determination of serum immunoglobulin G to P. aeruginosa was developed. Soluble antigens obtained by ultrasonication of P. aeruginosa, serotypes O:1 to O:17, were used as antigens immobilized to polystyrene microtiter plates. The intraplate, plate-to-plate, and day-to-day variations were 14, 19, and 20%, respectively. Plates coated with the antigens could be stored for at least 64 days at +4 and +22 degrees C without any significant change in activity. Normal values were determined in sera from 164 controls (100 children and 64 adults). The sensitivity and specificity of the ELISA was determined by using serum samples from 243 cystic fibrosis patients and were compared to results with crossed immunoelectrophoresis (CIE). The ELISA could diagnose chronic P. aeruginosa infection with a diagnostic sensitivity of 93% and specificity of 92%. The sensitivity and specificity for the diagnosis of the early stages of chronic P. aeruginosa infection by a single sample were 90 and 100%, respectively, and by using an increased antibody response in paired samples, the sensitivity was 93% and specificity was 87%. There was a statistically significant correlation between antibody levels obtained by ELISA and those obtained by CIE. The sensitivity and specificity of the ELISA were equal to those of CIE, and because of its simplicity, the ELISA is recommended as a routine test in patients with cystic fibrosis.

Adolescent↗
PubMed1986

An epidemic spread of multiresistant Pseudomonas aeruginosa in a cystic fibrosis centre.

Early in 1983 an epidemic of a Pseudomonas aeruginosa resistant to aminoglycosides, carbenicillin, ureidopenicillins, ceftazidime, cefsulodin and imipenem occurred in a cystic fibrosis centre. Most of the epidemic could be attributed to a specific nosocomial strain by means of O-grouping and phage-typing. This strain was present in the centre at a low frequency in 1973 and developed resistance during courses of chemotherapy. The epidemic was stopped by isolating patients with the resistant strains. Restrictive and selective use of antibiotics have not been sufficient to eradicate the resistant strains, which persist in 42% of the patients. The extensive use of the third generation cephalosporins in the clinic is probably responsible for inducing and selecting for the resistant strains. Clustering of patients in the centre has facilitated the spread. First-line use of older beta-lactam antibiotics, close bacteriological monitoring and prompt isolation of patients with resistant strains are recommended.

Adolescent↗
PubMed1986

Sultamicillin--a new antibiotic in the treatment of persistent lower respiratory tract infections caused by Haemophilus influenzae.

Haemophilus influenzae is a frequent cause of recurrent or chronic lower respiratory tract infections in patients suffering from cystic fibrosis (CF) and other chronic obstructive pulmonary disease (COPD). Ampicillin and its derivatives are routinely used in treatment, but resistant strains producing beta-lactamase frequently necessitate the use of other antibiotics. Sultamicillin is a compound agent for oral use in which ampicillin and the beta-lactamase inhibitor sulbactam are linked as a double ester. This combination is active in vitro against many beta-lactamase producing bacteria including ampicillin-resistant H. influenzae. Eight CF children and ten children with other COPD suffering from chronic or recurrent H. influenzae infection of the lower respiratory tract were treated with sultamicillin orally, 25 mg/kg, 12-hourly, for two weeks. Nine infections were caused by ampicillin-resistant strains. At the end of the treatment 65% of the patients were free of H. influenzae. The only adverse reaction was diarrhoea which occurred in 14 patients, and necessitated withdrawal of one patient from the study.

Adolescent↗
PubMed1986

Does centralized treatment of cystic fibrosis increase the risk of Pseudomonas aeruginosa infection?

Two hundred and forty Danish patients with cystic fibrosis (97% of the total CF population in Denmark) participated in a point-prevalence study of Pseudomonas aeruginosa infection. One hundred and ninety-two patients were treated at the Danish CF centre and 48 patients were treated in other places. The age distribution was significantly different as no patients older than 19 years were found in the non-centre group. Pathogenic bacteria were isolated from the sputum of 96% of the patients. P. aeruginosa was more prevalent in patients from the centre, whereas Staphylococcus aureus was more prevalent in the non-centre group. No difference in serogroup and phage pattern of P. aeruginosa was found. There was a tendency that non-centre treated patients acquired chronic broncho-pulmonary P. aeruginosa infection later, but at the age of 16 years 90% of all patients will be chronically infected. Chronic P. aeruginosa infection was significantly more common in the age group 10-14 years at the centre than outside the centre. It is not possible to prevent chronic P. aeruginosa infection in CF patients treated in small groups and because of the better prognosis of centralized treatment the latter must be recommended.

Adolescent↗
PubMed1985

Imipenem/cilastatin treatment of multiresistant Pseudomonas aeruginosa lung infection in cystic fibrosis.

Ten patients with cystic fibrosis and chronic broncho-pulmonary Pseudomonas aeruginosa infection received 45 mg imipenem/cilastatin per kg body weight/day, intravenously for two weeks. The treatment was safe with only minor side effects and clinical parameters improved considerably during therapy. In all patients resistance of Ps. aeruginosa to imipenem developed in the second week of treatment; in seven patients the therapy selected for a resistant strain and in three resistance developed in the original strain. The resistance persisted after cessation of treatment and thus the clinical usefulness of imipenem/cilastatin as monotherapy in CF-patients with Ps. aeruginosa seems to be limited.

Adolescent↗
PubMed1983

Surgical management of 85 perforations to the maxillary sinus.

A study is presented of 85 cases of perforation to the maxillary sinus closed within 48 h after appearance. All cases were treated with the Rehrmann buccal flap procedure or primary suture. 1 patient developed an oro-antral fistula and sinusitis and a further 3 patients developed sinusitis postoperatively. A detailed presentation of the cases with complications is made. The relationship between a non-infectious sinus and the treatment results is discussed and the importance of antibiotic treatment in addition to surgical intervention is stressed.

Adolescent↗