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Biomedical subjects

Y Aujard

Publications and source records attributed to Y Aujard.

At least 109 records · Page 6Linked to original sources
PubMed1986

[Determination of aminoglycosides in the newborn infant. Significance and methods].

Monitoring of serum aminoglycosides is useful in neonates to ensure therapeutic efficacy and avoid toxicity. The choice of a method must take in count several informations: sample size, versatility, sensitivity, specificity, precision, rapidity, equipment requirements and reagent cost. Many methods are now available: Microbiological assay, Radioimmunoassay (RIA) techniques, Radioenzymatic assay (REA), "High Pressure" liquid chromatography (HPLC), Fluorescent immunoassay, Enzyme-Multiplied Immunoassay (EMIT) and Fluorescent polarization Immunoassay (FPIA). Microbiological assay is inexpensive but has major disadvantages: lack of specificity, low precision, requires 24 to 48 hours, large sample size. EMIT and FPIA are rapid, sensitive, highly specific and particularly adapted to the pediatric use but reagent are expensive.

Aminoglycosides↗
PubMed1986

[Pharmacokinetics and toxicity of gentamycin in the newborn infant].

Gentamicin, as the other aminoglycosides, has a very narrow therapeutic index. The pharmaco-kinetics parameters in neonates depend on the renal maturation which is a function of post-conceptional age. Using an unit dose of 2 mg/kg and adapted time intervals, longer for premature babies and in the first week of life, the frequency of too high trough levels is decreased. A convenient method is proposed for determining when to reduce the time interval between injections. Audiotoxicity is both cochlear and vestibular and can be, only in part, detected by evoked potentials. Nephrotoxicity is initially, a tubular injury with an increase of enzymuria (NAG) and beta 2 microglobulinuria, followed by alterations of glomerular filtration. Blood concentrations monitoring is indicated in all gentamicin treated neonates.

Gentamicins↗
PubMed1985

Impact of cefotaxime on the fecal flora in children.

A differential quantitative analysis was used to study the effect of cefotaxime on the fecal flora in 26 hospitalized children ranging from two days to four years of age. Fecal specimens were obtained before, during and after therapy. This study was evaluated in comparison to 41 patients of the same age and from the same environment without antibiotic treatment or signs of infection. The fecal flora of the control group showed qualitative and quantitative stability. Two groups of species were distinguished: a group in which the upper limit was less than or equal to 10(7) bacteria/g of stool (Klebsiella, Enterobacter, other enterobacteria, Staphylococcus, Pseudomonas) and a group with less than or equal to 10(10) bacteria/g of stool (anaerobes, Escherichia coli, Streptococcus D). This stability of the control group of subjects allowed us to interpret the variations of microbial concentrations during and after cefotaxime treatment. In previous studies, we showed in the newborn a substantial risk of septicemia of intestinal origin when overgrowth occurred, especially with Klebsiella. With cefotaxime there was a decrease or a disappearance in 65% of E. coli and a slight decrease of Klebsiella and Enterobacter. This fact was of great interest in the treatment of endogenous secondary septicemia. We observed an appearance of Pseudomonas (nine Pseudomonas aeruginosa, two Pseudomonas putida, one Pseudomonas fluorescens) in 12 cases among the 26 children treated.(ABSTRACT TRUNCATED AT 250 WORDS)

Bacteria↗
PubMed1985

[Pulmonary valve stenosis. The medical solution].

Pulmonary valvular stenosis had been diagnosed since infancy in a 3 year-old girl. Cyanotic episodes occurring when the child cried led to the decision to remove the stenosis, whose gradient was 58 mmHg. Transluminal dilatation through the femoral vein, after premedication and local anesthesia induced a decrease of the gradient to 18 mmHg with a good angiographic result. This technique, which may be used in numerous types of pulmonary stenosis, allowed avoidance of the disadvantages of surgery under general anesthesia with median sternotomy and cardiopulmonary by-pass.

Angioplasty, Balloon↗
PubMed1984

[Influence of amoxicillin combined with clavulanic acid on the fecal flora in children].

The effect of an amoxycillin-clavulanic acid combination on the intestinal bacterial ecosystem was studied by differential quantitative analysis of the fecal flora in 11 hospitalized pediatric patients aged 8 months to 4 years. The antibiotic combination was given orally to 7 patients and intravenously to 4. The modifications in the intestinal flora are more important with oral route than intravenous route. After treatment, an increase in ampicillin-resistant E. coli with overgrowth of Klebsiella were found. Our previous studies have shown that this microbial overgrowth carries a risk of secondary septicemia. A strain of amoxycillin-resistant Serratia marcescens emerged but did not pullulate . The other aerobic or anaerobic bacteria were not significantly modified. Most strains which emerged after therapy remained susceptible to the combination. Yeasts emerged in two patients. Thus, the amoxycillin-clavulanic acid combination results in intestinal Klebsiella overgrowth, requiring monitoring of the intestinal bacterial ecosystem.

Amoxicillin↗
PubMed1984

[Influence of cefoperazone on the fecal flora in children].

A differential quantitative study was used to evaluate the effects of parenteral cefoperazone upon children's fecal flora. Fecal specimens were obtained from 16 patients, before, during and after therapy. Cefoperazone therapy was associated with major changes in fecal flora. There was marked reduction or suppression to undetectable levels of Enterobacteria, Staphylococci and Streptococci in 13 patients. During therapy, yeasts were selected or acquired in 7 cases. 5 to 10 days after cefoperazone was discontinued, the fecal flora was virtually the same as before treatment. Thus, cefoperazone should prove very useful in the treatment of septicemia due to intestinal overgrowth.

Adolescent↗
PubMed1982

[Relevance and applications of systematic quantitative determinations of gentamicin during the neonatal period (author's transl)].

We have used an enzyme immunoassay method to measure serum levels of gentamicin in neonates according to gestational age, birth weight, dosage and intervals of intramuscular injections. Peak, predose serum levels and half-life decrease when gestational age increase. For the same gestational age, peak serum levels decrease in small weight neonates. Toxic postdose serum levels were obtained in preterm neonates with a daily regimen exceeding 5 mg/kg. Serum concentration monitoring of gentamicin is recommended to ensure adequate dosage and interval of injections.

Bacterial Infections↗
PubMed1981

[Cefotaxime and Gram-negative infections in children. Effectiveness and tolerance (author's transl)].

Twenty-six children, aged from 15 days to 14 years, were treated with cefotaxime. 5 were suffering from septicaemia, 14 from respiratory tract infection and were ventilated (intensive care unit), 4 from urinary tract infection and 3 from otitis media complicated with renal failure (nephrology unit). The choice of cefotaxime treatment was based upon the bacterial activity. The daily dose was 50 to 100 mg/kg by the i.m. route, or by slow intravenous injection every 8 hours. In 17 patients, cefotaxime was combined with an aminoglycoside (gentamicin or amikacin). The results were evaluated on the basis of clinical, radiological and bacteriological criteria and, whenever possible, were correlated to the serum levels of antibiotic. The antibiotic was clinically effective in 25 out of 26 patients. The three deaths that occurred, were due to the nature of the initial disease. Tolerance was good in all the patients studied. The efficacy of cefotaxime correlated well with the favorable in vitro bacteriological results and with serum concentrations. Cefotaxime is well tolerated as shown in newborn babies. Cefotaxime is markedly different from previous cephalosporins, because of its high antibacterial activity on most Gram-negative bacilli.

Adolescent↗
PubMed1980

Fulminant meningococcemia in a child with hereditary deficiency of the seventh component of complement and proteinuria.

A previously healthy 14-year-old boy presented with fulminant meningococcemia. He was found to have a total deficiency of C7. His serum totally lacked bactericidal activity against Neisseria meningitidis. Addition of purified C7 restored the serum hemolytic and bactericidal activity. Susceptibility to disseminated Neisseria infections has previously been reported in 3 patients with C7 deficiency, as well as in a few patients with deficiency of C5, C6 and C8. These findings emphasize the importance of intact complement mediated bactericidal activity in host defense against disseminated Neisseria infections. Evaluation of the complement system in individuals with Neisseria infections appears mandatory.

Adolescent↗