Tularemia in a Wisconsin resident--a reminder.
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Aged↗
Biomedical subjects
T R Franson
Publications and source records attributed to T R Franson.
Treatment of twelve burn wound infections and eight other serious infections with cefazolin and tobramycin: in vitro and in vivo evaluation.
20 patients with serious infections were treated with cefazolin and tobramycin for 9--64 days. Minimal inhibitory concentration (MIC) values and minimal bactericidal concentration (MBC) values were determined for each of the 112 clinical bacterial isolates. The median cefazolin MIC/MBC was 1.56/12.5 micrograms/ml, and the median tobramycin MIC/MBC was 6.25/25.0 micrograms/ml for all organisms studied. Median cefazolin doses of 49.0 mg/kg/day gave median peak/trough serum levels of 43.0/11.0 micrograms/ml. Median tobramycin doses of 4.3 mg/kg/day gave median peak/trough serum levels of 5.0/1.4 micrograms/ml. Checkerboard studies revealed synergy with 65% of strains. Bacteriologic and clinical success was obtained in 17 of 20 patients.
Acute Kidney Injury↗
Cefazolin treatment of bacterial infections. In vitro and in vivo evaluation.
Cefazolin sodium was used to treat 20 serious bacterial infections in 19 patients, 11 of whom were infected by coagulase-positive Staphylococci. Clinical and bacteriologic success were initially obtained in 15 patients with 16 infections. 2 additional patients were cured after surgery for removal of foreign bodies and a second course of the antibiotic. 1 asplenic patient had bacteremia and died 5 days after initiating therapy with negative blood cultures and multiple abscesses. 1 patient with endocarditis relapsed 19 months after treatment with 6 weeks of cefazolin and prolonged oral antibiotics. Calculated median, trough, free drug levels were 1.5--15.3 times the minimum inhibitory concentration for 27 of 29 pathogens.
Adult↗
Drug pharmacokinetics in patients with renal failure.
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Dose-Response Relationship, Drug↗
Frequency and characteristics of hyperbilirubinemia associated with bacteremia.
One hundred consecutive patients with blood cultures positive for microbial growth were prospectively surveyed for the presence of hepatic abnormalities and clinical evidence of infection. Complete data for 82 patients were available for analysis. Fifty-four percent had elevated bilirubin levels, and 34% had total bilirubin values of greater than or equal to 2.0 mg/dl. The levels of total bilirubin were disproportionately elevated compared with those of aspartate aminotransferase, alkaline phosphatase, and cholesterol. Nine of the 23 patients with elevated bilirubin levels had an increase in serum bilirubin one to nine days before their initial positive blood culture. Disproportionate elevations of direct and total serum bilirubin values compared with values for other liver-function tests appear to be associated with bacteremia in adults more frequently than previously recognized and may have some predictive value in such patients.
Adolescent↗
Aminoglycoside serum concentration sampling via central venous catheters: a potential source of clinical error.
Two patients receiving aminoglycosides via central venous Silastic catheters were noted to have serum drug concentrations markedly divergent from expected results. Study of these patients, and of four additional patients prospectively selected for study, demonstrated that three of five patients had higher peak and/or trough aminoglycoside serum concentrations--when blood was obtained from the central venous catheter--than were contained in simultaneous samples from peripheral blood; these divergent results were noted after the catheter had been in use for more than 1 week; divergent results were not improved by additional catheter flushing prior to central venous blood sampling. These observations suggest that spurious aminoglycoside serum concentration results may sometimes be obtained when blood sampling is performed from central venous Silastic catheters, and can result in improper drug dosage alterations. It is necessary to access the timing, processing, and reliability of serum drug-monitoring practices on a routine basis to preclude such problems, and to reassess individual patient-monitoring studies which are inconsistent with anticipated results.
Adult↗