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Biomedical subjects

W Marget

Publications and source records attributed to W Marget.

At least 37 records · Page 2Linked to original sources
PubMed1980

Intravenous cefotaxime in children with bacterial meningitis.

Thirteen children with meningitis due to Haemophilus influenzae, beta-haemolytic streptococcus group B, Streptococcus pneumoniae, Staphylococcus epidermidis, Neisseria meningitidis, Escherichia coli, or Pseudomonas aeruginosa and who had been unsuccessfully treated with other antibiotics or had causative organisms which were resistant to available antibiotics were treated with intravenous cefotaxime. Nine children were cured; in one case infection (with a different organism) recurred but a further course of cefotaxime was successful; one child died, with sterile CSF; one child died from his underlying disease (astrocytoma); and one child was cured with sequelae (hydrocephalus). A further child with meningitis caused by E. coli had been treated unsuccessfully by intravenous and intraventricular chloramphenicol and gentamicin; intravenous and intraventricular cefotaxime was successful. The agent was well tolerated. CSF levels were measured in seven children and ranged from 300 to 27 200 microgram/l; published and unpublished in-vitro studies suggest that minimum inhibitory concentrations for cefotaxime against the organisms commonly causing bacterial meningitis are usually well below 250 microgram/l.

Biological Availability↗
PubMed1980

Diagnosis and therapy of anaerobic infections in childhood.

There are two main periods of manifestation of anaerobic infections in childhood. In the neonatal period anaerobic septicaemia is usually mild with a lower mortality rate, but has essentially the same causes as aerobic septicaemia (premature rupture of the membranes, amniotic infection syndrome after ascending infection). The latter cases comprise about 10% of aerobic septicaemias. Later in childhood, the pathogenesis of anaerobic infections is similar to that in adulthood. Anaerobic infections occur after surgery, particularly of the abdominal region, in malignancies, immunodeficiency and aspiration. With the exception of Bacteroides fragilis, most anaerobes are sensitive to penicillin. A high percentage of clinically important anaerobes are sensitive to clindamycin, chloramphenicol and metronidazole.

Anaerobiosis↗
PubMed1980

[Chlamydia trachomatis as pathogen in pneumonia in a newborn infant (author's transl)].

A report is given of a newborn who developed signs of hepatitis two weeks after a normal birth, and only later respiratory symptoms of pneumonia. The infant had pronounced tachypnea, incresed immunoglobulins, eosinophilia and leucocytosis. X-rays in the initial stages showed interstitial infiltrates with alveolar hyperaeration, and in the later stages patchy alveolar infiltrates. Chlamydia trachomatis was cultured from the tracheal secretion. In making a differential diagnosis in cases of neonatal pneumonia infection with trachomatis must thus also be considered.

Anti-Bacterial Agents↗
PubMed1980

Guidelines for adequate chemotherapeutic dosage in newborns and infants with septicaemia and meningitis.

The chemotherapy of septicaemia in newborns differs fundamentally from that in older children or adults because, although newborns have a fully developed immunological system, the system has not yet "learned" to operate completely. Ultimately, optimal chemotherapy can only be found empirically. In this respect a few basic guidelines can be given however: 1. The initial therapy must bring the pathogen under control with a high degree of certainty, since a correction in therapy following pathogen indentification is usually too late. 2. Since the pharmacokinetics of antibiotics in newborns vary considerably, the minimal peak serum concentration observed should exceed the MIC of the pathogen. 3. In rapidly maturing newborns and premature babies the pharmacokinetics of each antibiotic must be known precisely. 4. Since in the individual case there can never be absolute certainty with respect to the three above-mentioned problems, combination therapy should be given at all times.

Amikacin↗
PubMed1979

[Endocarditis therapy with high doses of oral doxycycline: Part II: Clinical study (author's transl)].

Nineteen patients previously treated unsuccessfully, usually with bactericidal antibiotics, received large doses (average: 15-20 mg/kg/day) of oral doxycycline (Vibramycin) after suitable testing for resistance. The good therapeutic results -- complete cure in eleven cases, great improvement in one, doubtful response to doxycycline in four, three failures -- justifies the observation that high oral doses of doxycycline can be considered as an important addition to the possibilities for treatment of endocarditis.

Administration, Oral↗
PubMed1979

[Nosocomial infections (author's transl)].

Within 3 years 2546 nosocomial infections were registered among 18 897 hospitalised patients of a gynaecological-obstetric university hospital, Results were obtained in a prospective study on the use of nurses specially trained in hygiene. The incidence of nosocomial infections was 13.5% including predominantly asymptomatic bacteriurias and 3.9% without bacteriurias. It was higher after major surgical intervention and lowest in pregnant women, postnatal patients, vaginal deliveries and minor operations. Bacteriurias were the most common infection in all patient groups. They made up 71% of the total, followed by postoperative pelvic infections (7.3%), phlebitis at the site of infusion (6.5%) and abdominal wound infection (4.2%). During the control programme, introduction and reinforcement of various hygienic measures and continuous instruction and control of the wards and treatment rooms by the specially trained nurses the incidence of all nosocomial infections decreased by 48.1% and of urinary tract infections by 42.7%.

Bacteriuria↗
PubMed1979

[Preventive and therapeutic application possibilities of newer antibiotics (author's transl)].

Today, however aminoglycosides are nearly indispensable owing to their broad antibacterial spectrum and genuine bactericidal effect as well as the possible synergic effect with beta-lactam preparations. The new cephalosporins are distinguished by a high beta-lactam stability and are active against the majority of pathogens causing nosocomial infections. An exceptional position is held by cefotaxim with its generally outstanding antibacterial potency, and by cefoxitin with its activity against Bacteroides fragilis. The ureidopenicillin azlocillin is superior to the Pseudomonas penicillins so far used. It acts against enterococci and H. influenzae as reliably as does mezlocillin.

Aminoglycosides↗
PubMed1979

The immunological state of the neonate following surgery--consequences for immunotherapy of neonatal septicaemia.

In addition to an innate functional dysmaturity of the neonate's immune system, operation, anaesthesia, and intensive care measures can significantly worsen this physiological immune deficiency. Given the fact that antimicrobial therapy as well as progress in intensive care of infected operated neonates and prematures did not significantly decrease the high mortality rate in this patient age group we began performing fresh-blood exchange transfusions as supportive immunotherapy in the treatment of neonatal septicaemia. Since indication for exchange transfusion has been adopted as early as septicaemia was suspected only 46% of the operated neonates (13 out of 28) died of their infection, compared to 82% of the patients (23 out of 28) who did not undergo exchange transfusion.

Exchange Transfusion, Whole Blood↗
PubMed1978

[New aspects of the value of endotoxins in various gastrointestinal diseases].

Recent investigations of several authors on portal venous and systemic endotoxemia in healthy adults have shown that endotoxins absorbed from the intestinal mucosa are found in portal venous blood, cleared by the RES of the liver and usually cannot be determined in peripheral blood. In patients with liver disease, however, there was often a reduced endotoxin clearance with spillover of endotoxin resulting in systemic endotoxemia. Among the complications of systemic endotoxemia, hepatocytotoxicity, pyrogen reaction, disseminated intravascular coagulation, impaired renal function, and endotoxic shock are most hazardous. In addition, O-antibody titers and lipid-A-antibody titers were found to be higher in patients with liver disease and in patients with Crohn's disease than in control groups. The investigations indicate that intestinal endotoxins are of importance in the pathogenesis of liver disease and of Crohn's disease and that reduction of intestinal endotoxins by antibiotics may be of value in the therapy of these diseases.

Antigens, Bacterial↗