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Biomedical subjects

W Stille

Publications and source records attributed to W Stille.

At least 109 records · Page 6Linked to original sources
PubMed1983

[Clinical use of new cephalosporins for severe infections in internal medicine].

Our clinical experience with new antibiotics giving special consideration to the individual cephalosporin groups is discussed. Although newer cephalosporins from cefamandol and cefoxitin to cefotiam and cefoperazon already showed increased effectiveness (for example, cefoxitin in bacteroides infection) in comparison to older ones, the real breakthrough regarding enterobacteriaceae was only made with cephalosporins of the cefotaxime group. This group's main indication is non-specific initial therapy of severe nosocomial infections, especially processes in which the presence of resistant enterobacteriaceae must be assumed. Because of its broad spectrum of action, cefotaxime can to a large extent replace the combinations with aminoglycosides which were used previously. When required, cefotaxime proves to be a good partner for combinations with pseudomonas antibiotics.

Bacteroides Infections↗
PubMed1982

[Clinical experience with non-specific broad-spectrum antibacterial chemotherapy (author's transl)].

49 patients were given cefoxitin in combination with azlocillin, and 15 were given an aminoglycoside as well when severe bacterial infection was suspected. In 39 cases a prompt amelioration of the clinical signs of infection was observed. Of the 17 patients who died, a post-mortem was performed in seven; only in four were signs of bacterial infection present; one had tuberculosis and one had a cytomegalovirus infection. The combination therapy was well tolerated and side-effects were rare; no bleeding complications were seen. Clinical signs of possible antagonism between the two beta-lactam antibiotics were not observed.

Adult↗
PubMed1982

[Investigations on antibacterial activity of apalcillin].

In 201 clinical isolates the antibacterial activity of (2S,5R, 6R)-6-[(R)-2-(4-Hydroxy-1,5-naphthyridine-3-carboxamido) -2-phenylacetamido]-3,3-dimethyl-7-oxo-4-thia-1-azabicyclo [3.2.0]heptane-2-carbonic acid (apalcillin, PC-904) a new semisynthetic broad spectrum penicillin, was tested. The activity was almost equal to piperacillin, the at present optimal penicillin derivative, but against pseudomonas apalcillin was clearly superior. Lack of activity as compared to the acylureidopenicillins was found in proteus species whilst its activity against E. coli and klebsiella species was higher. Antagonism was observed in pseudomonas aeruginosa for the combination of apalcillin and cefoxitin which also existed with azlocillin or piperacillin and cefoxitin.

Ampicillin↗
PubMed1981

[Acute virus hepatitis and venereal infection (author's transl)].

100 patients with acute viral hepatitis were examined. In 10 of these the infection was found to be associated with homosexual activity and in 7 with promiscuity. Sexual intercourse was a likely cause of infection in 61% of all men aged from 20-40 years who had contracted hepatitis B by a non-parenteral route. Of these patients, 8 had acute syphilis and 2 had acute gonorrhea along with their hepatitis. The clinical course of the hepatitis was more severe in the group of syphilitic patients than in the controls. These observations indicate that simultaneous venereal disease influences the incidence and course of acute viral hepatitis.

Acute Disease↗
PubMed1981

[Bacterial elimination and antibiotic concentration in the gall-bladder during biliary tract infections treated with mezlocillin (author's transl)].

A transpapillary indwelling catheter was placed in 15 patients with choledocholithiasis and threatened occlusion by stone. Ten of the 15 patients had marked biliary stasis, four had signs of acute cholangitis. In all patients E. coli was present in the gall-bladder in a concentration of greater than or equal to 10(5)/ml when the catheter was first inserted. The bacteria were sensitive to mezlocillin, at a minimal inhibitor concentration between 1.5 and 16 micrograms/ml. All patients received mezlocillin, 5 g twice daily, in a short-term infusion. Immediately before and regularly thereafter bile samples were taken to measure antibiotic concentration and bacterial counts (by membrane filtration). Mezlocillin was excreted in the bile in very high concentrations in patients without biliary stasis. But while the concentrations were markedly lower in those with stasis, they were still 10 to 100 times the minimum inhibitory concentration of mezlocillin against the appropriate strains. In keeping with the high mezlocillin concentration, bacterial counts fell much more quickly in the patients without stasis than in those with alkaline phosphatase concentration above 250 U/l. These differences were even more marked after two or three days. Bacterial elimination from bile was complete in two of three patients with normal alkaline phosphatase activity, but in only one of five in whom it was elevated.

Aged↗
PubMed1981

[In vitro studies on dosing interval of cefoperazone (author's transl)].

Serum pharmacokinetics of 1 g cefoperazone was simulated in vitro. Initial concentration was 190 microgram/ml, half-life 128 min. Bactericidal activity and regrowth interval was determined against 17 clinical isolates. Rapid initial killing was seen especially against E. coli, K. pneumoniae and E. cloacae and with some reservations also against P. aeruginosa. The bactericidal activity was slower against P. mirabilis and S. aureus. Only 8 out of 17 tested strains regrew to 1% mark between 8.5 and 12 h after exposure to cefoperazone was started. The regrowth interval ranged from 0.5 to 6.5 h.

Bacteria↗
PubMed1980

[Infections in intensive care medicine].

Severe bacterial, parasitic or viral infections should be treated in an intensive therapy ward. On the other hand, patients in intensive therapy wards are threatened by secondary bacterial infections which are above all evoked by so-called problem germs. In the first place, chemotherapy is based on modern penicilline and/or cephalosporins, mostly in combination with a modern aminoglycoside. Septicaemias are evoked above all by gram-negative bacilli or by Staph. aureus. A special form is the infusion septicaemia by so-called water germs, which in most cases cannot be cultivated at 37 degrees C. Furthermore, the author enters the infections by venous catheter, infections of the urinary tract and infections of the respiratory tract in intensive therapy patients, which up to now are an unsolved problem. This problem cannot be solved, too, by means of essentially improved antibiotics alone. However, it would be useful to renounce for example every unnecessary catheterisation of the urinary bladder. The control of the excretion or aleviations of cure are no arguments for the insertion of a permanent catheter.

Anti-Bacterial Agents↗
PubMed1980

Chemotherapeutic aspects of anaerobic septicemia.

The author discusses the incidence as well as diagnostic and therapeutic aspects of Bacteroides septicemia. The disease is often polymicrobic and may be lethal even with optimum antibiotic treatment.

Anti-Bacterial Agents↗
PubMed1980

Dose-activity relationships in chemotherapy.

The in vitro antibacterial effects of subinhibitory and suprainhibitory concentrations of a number of beta-lactam antibiotics and aminoglycosides on microbial growth are presented. The type and extent of the subinhibitory activity of a drug can be well defined by means of growth curves obtained with different subinhibitory concentrations; from these values one can deduce and define the minimal active concentration (MAC) as the concentration at which morphological alterations or inhibition of growth of the bacteria can be seen. The effect of suprainhibitory concentrations can be evaluated by studying the kinetics of the bactericidal activity of a drug. Different types of bactericidal dose-activity relationships can be observed; in many cases a minimal optimal concentration (MOC) can be defined as the lowest concentration of a drug which causes no further appreciable enhancement of efficacy on increasing the concentration. Usually chemotherapy is carried out at subinhibitory drug levels--with decreasing and increasing concentrations--and at present it would appear difficult to assess these constant changes in an in vitro test. Bacteriologists should thus take into account the clinicians' demands for more precise bacteriological data on antibacterial agents.

Dose-Response Relationship, Drug↗