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[Amikacin in urinary tract infections with so-called problem pathogens].

Amikacin (Biklin) was applied in 33 patients with and without renal insufficiency, suffering of non-obstructive inflammations of the urinary tract, caused by multiple resistant hospital germs. The dosage was 125.0--1000.0 mg/die, injected as short infusion and solved in dextrose 5%. The serum and urine concentrations were measured simultaneously. In 18 cases an infection could not be seen after a control period of 8 days up to 4 weeks. Persistence of bacteria happened in five cases. Reinfection could be noted in 5 other cases. Side effects--as oto- or nephrotoxicity, pathological changes of the differential blood count, increasing of the serum transaminases and phosphatases--were seen neither during nor after the therapy.

Amikacin↗

[Chemotherapeutic effectiveness of rifampicin in experimental infections].

Studies on the chemotherapeutic action of rifampicin in treatment of staphylococcal sepsis and sepsis caused by gramnegative organisms showed its high efficacy only in treatment of the staphylococcal infection. By the level of its efficacy rifampicin was much superior to benzylpenicillin and especially tetracycline. No difference in the activity level of the antibiotic in treatment of staphylococcal infections caused by sensitive and multiple resistant staphylococcal strains was found. In treatment of the infections caused by gramnegative organisms the drug activity was moderate.

Acute Disease↗

[Therapeutic effect of cefluprenam on polymicrobial urinary tract infection associated with Enterococcus faecalis, using the infectious urolithiasis model in rats].

We examined the therapeutic effect of cefluprenam (CFLP) on the polymicrobial urinary tract infection associated with infectious stones as compared to that of ceftazidime (CAZ), using the experimental polymicrobial urinary tract infection caused by Proteus mirabilis (P. mirabilis), Pseudomonas aeruginosa (P. aeruginosa) and Enterococcus faecalis (E. faecalis). In order to form bladder stones in rats, a sterile zinc ring was implanted as a foreign body, followed by inoculating P. mirabilis E05106 transurethrelly. Thereafter, P. aeruginosa E030033 and E. faecalis 966 were inoculated according to the same way. CFLP or CAZ was administered intravenously twice a day for 5 days. The therapeutic effect was evaluated by the eradication of these bacteria from the urine, the kidney and stones, inhibition of growth of stones, and also a value of BUN. The urinary excretion rates of CFLP and CAZ was also determined (20 mg/kg). In result, CFLP significantly more effective in the eradication of P. mirabilitis, P. aeruginosa and E. faecalis from the urine, the kidney and stones than the control than the control (p < 0.05). Furthermore, CFLP significantly more effective in the eradication of P. aeruginosa from the urine and also E. facalis from the urine and stones (p < 0.05). Meanwhile, CAZ significantly more effective in the eradication of P. mirabilis from the urine, the kidney and stones and also P. aeraginosa from the kidney and stones than the control. However, CAZ did not show eradicative effect on E. faecalis. The urinary excretion rates of CFLP and CAZ at rats were 59.3% and 59.4%, respectively, within 8 hrs after administration, showing a similar excretion pattern. CFLP exhibited the prominent therapeutic effect on polymicrobial urinary tract infection associated with infectious stones caused by P. mirabilis, P. aeruginosa and E. faecalls. On the basis of these results, it has been strongly suggested that CFLP is highly beneficial in the management of intractable polymicrobial urinary tract infectious in clinic.

Animals↗

Nonclostridial gas gangrene.

Although nonclostridial gas gangrene is not an unusual occurrence, relatively few cases including the distal lower extremity have been reported. Due to the serious nature of some of these infections, it is important for physicians to familiarize themselves with these nonclostridial crepitant infections, which are often confused with clostridial myonecrosis. Etiology, evaluation, and treatment is described by the authors. Also, a case study is presented.

Adult↗

Late presentation of infection as a complication of Dwyer anterior spinal instrumentation.

Delayed presentation of infection is a rare complication of anterior instrumentation and fusion for scoliosis. Three cases that followed the Dwyer procedure are reported. Pain was absent in these patients, but mild constitutional symptoms were present. An elevated erythrocyte sedimentation rate (ESR) is an important indicator of this complication. Two patients developed groin abscesses and sinuses as the hallmark of deep infection. Infection resolved after removal of instrumentation and local debridement.

Adolescent↗