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Biomedical subjects

S V Iakovlev

Publications and source records attributed to S V Iakovlev.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Multicenter open randomized trial of meropenem in comparison to ceftazidime and amikacin used in combination in severe hospital infections].

Clinical efficacy and tolerance of meropenem were estimated by comparison with those of ceftazidime and amikacin used in combination in the therapy of hospital infections of the lower respiratory tract, skin and soft tissues, intraabdominal and gynecologic infections, urinary tract infection and sepsis. 48 patients were given meropenem in a dose of 1 g every 8 hours for 3-14 days (the average of 9 days). 47 patients were subjected to the routine combined therapy: ceftazidime in a dose of 1 g every 8 hours and amikacin in a dose of 0.5 g every 12 hours for 2-14 days (the average of 9 days). The patient groups were comparable by the age, nature and severity of the infection and the condition (the mean APACHE II of 9.1 and 8.9). By the end of the treatment a positive clinical effect (recovery and improvement) was observed in 47 patients (97.9 per cent) treated with meropenem and in 41 patients (89.1 per cent) subjected to the combined therapy. The infection relapse within 4 weeks after the treatment completion was recorded in 3 patients in every group. Before the treatment 133 microbial strains were isolated from the patients. 121 of them were susceptible to meropenem (91.1 per cent), 111 to amikacin (83.4 per cent) and 90 to ceftazidime (67.7 per cent). The difference between meropenem and ceftazidime was significant (p = 0.0005). Eradication of the primary pathogens at the background of the meropenem therapy was stated in 41 out of 44 patients (93.2 per cent) and that of the combined therapy in 38 out of 43 patients (88.4 per cent). The microbiological relapse after the treatment completion was recorded in 3 and 2 patients, respectively. Side effects were observed in 8.3 per cent of the patients treated with meropenem and in 10.6 per cent of the patients subjected to the combined therapy. The trial results were indicative of the meropenem high efficacy and good tolerance and of the possible use of the drug in the monotherapy as an alternative of the routine combined therapy of severe hospital infections.

Adolescent↗
PubMed1998

[Stepwise therapy of community-acquired pneumonia. Results of cefuroxime and cefuroxime axetil study].

The efficacy of a 7-day switch therapy with parenteral cefuroxime in a dose of 750 mg for 3-5 days followed by the use of oral cefuroxime axetil in a dose of 500 mg every 12 hours was compared with that of a 7-day therapy with parenteral cefuroxime in a dose of 750 mg every 8 hours in hospitalized patients with community-acquired pneumonia. The clinical and bacteriological efficacies and pharmacokinetic properties of both the dosage forms were estimated. It was shown that the clinical and bacteriological effects did not significantly differ in the patients under the parenteral regimen with cefuroxime and under the parenteral-to-oral regimen with cefuroxime and cefuroxime axetil: the cure in 75 and 83 per cent of the patients and the bacteriological response in 100 and 86 per cent of the cases respectively. The results indicated that the cost of the switch therapy was much lower while the efficacy did not decrease.

Administration, Oral↗
PubMed1998

[Program of empirical antibacterial therapy of community-acquired pneumonia].

Clinical and bacteriological efficacies of some antibacterial agents were estimated with their differential use in the management of various groups of patients with community-acquired pneumonia. Group 1 included young and middle-aged patients with mild pneumonia. Group 2 included young and middle-aged patients with moderate pneumonia. Group 3 included elderly patients with pneumonia and/or patients with concomitant diseases or certain factors complicating the main process. The patients of group 1 were treated with roxithromycin and spiramycin and showed a rapid clinical effect in 100 and 86 per cent of the cases and a rapid bacteriological effect in 84 and 75 per cent of the cases respectively. The patients of group 2 were treated with parenteral cefuroxime with positive clinical and bacteriological effects in 68 and 78 per cent of the cases respectively. The patients of group 3 were treated with ceftibuten and pefloxacin which provided a clinical effect in 91 and 70 per cent of the cases and a bacteriological effect in 72 and 100 per cent of the cases respectively. The results of the treatment with an account of the differences in the pathogen spectra made it possible to recommend as the 1st order agents for the empirical therapy of community-acquired pneumonia (1) macrolide antibiotics for young and middle-aged patients with mild pneumonia without concomitant diseases, (2) 2nd generation cephalosporins for patients with moderate pneumonia without severe concomitant diseases and (3) 3rd generation cephalosporins or fluoroquinolones for elderly patients with pneumonia and the patients with complicating factors.

Administration, Oral↗
PubMed1997

[Use of piperacillin/tazobactam as empirical monotherapy in the treatment of bacterial infections in a resuscitation department].

Fifteen patients with severe bacterial infection (12 with pneumonia) that developed in the resuscitation unit were subjected to the empirical monotherapy with piperacillin/tazobactam (P/T) or tazocin under an open randomized controlled experiment. P/T was administered intravenously in a dose of 4.5 g every 8 hours for 5 to 12 days (9.3 days on the average). When the monotherapy was not sufficiently efficient the patients were additionally treated with amikacin administered intravenously in a dose of 0.5 g every 8-12 hours. The favourable effect was observed in 14 patients (93 per cent). 7 of them were treated with P/T alone and 7 were treated with P/T in combination with amikacin. The primary pathogens were eradicated in 8 (73 per cent) out of the 11 patients treated with P/T alone. Before the treatment 34 microbial strains were isolated from the patients. 77 per cent of them were susceptible to P/T. The treatment with P/T resulted in eradication of 27 bacterial strains (79 per cent) including 67 per cent of gram-positive organisms and 86 per cent of gram-negative organisms. The adverse effects were recorded in 1 patient on the 6th day of the treatment: skin eruption and pruritus that required the treatment discontinuation. The results showed that the use of P/T in the initial empirical monotherapy of infections in patients under resuscitation conditions could be efficient.

Adult↗
PubMed1997

[The pharmacokinetics of fluoroquinolones in different diseases].

A literature review on the pharmacokinetic characteristics of fluoroquinolones in the treatment of patients with various diseases such as diseases accompanied by hepatic insufficiency, mucoviscidosis, diseases in elderly patients, lower respiratory tract infection, septicemia, skin infection and others was analyzed. Infections requiring correction of the routine treatment regiments are indicated.

Anti-Infective Agents↗
PubMed1996

[Infectious complications in patients in the terminal stages of chronic renal insufficiency].

Characteristics of infectious complications were investigated in 112 patients at the terminal stage of renal insufficiency treated by programme hemodialysis. High frequency of sepsis (32.4 per cent), urinary tract infections (27.7 per cent), respiratory tract infections (26.4 per cent) and tuberculosis (5.6 per cent) was stated. The lethal outcomes of the infectious complications averaged 20.3 per cent.

Adolescent↗