Ciprofloxacin in the prevention and treatment of surgical infections]

A clinico-laboratory study on ciprofloxacin made by Bayer (Germany) was applied to patients with extended posttraumatic wounds and performed with the aim of preventing postoperative purulent complications in patients operated on the organs of the gastrointestinal tract. In the both groups ciprofloxacin was administered orally in doses of 500 and 1000 mg and intravenously in a dose of 200 mg. The results of the assay on ciprofloxacin sensitivity of the isolates from the wound excretion and urine showed that they were more sensitive to ciprofloxacin than to aminoglycosides and cephalosporins. 15 minutes after the intravenous administration the serum concentration of ciprofloxacin amounted to 7.5 +/- 0.9 micrograms/ml and in 6 hours it was equal to 0.45 +/- 0.45 micrograms/ml, the mean concentrations of ciprofloxacin being attained in the bile (8.7 +/- +/- 3.9 micrograms/ml), gallbladder wall (5.5 +/- 3.8 micrograms/g), liver (0.73 micrograms/g), muscles (1.93 micrograms/g) and tendon (0.15 microgram/g). After the oral administration in a dose of 500 mg ciprofloxacin was detected in the blood serum in an amount of 2.0 +/- 0.7 micrograms/ml in 1 hour and in an amount of 0.9 +/- 0.13 micrograms/ml in 6 hours. After the drug oral administration in a dose of 1000 mg the maximum concentrations were: 6.34 +/- 4.2 micrograms/ml on the average and 2.1 +/- 0.8 micrograms/ml in 6 hours (0.4 micrograms/g in the muscles, 1.4 micrograms/g in the skin and 0.34 micrograms/g in the bones). The study showed that ciprofloxacin was a highly efficient antimicrobial agent in the treatment of the complicated wound infections and the prophylaxis of the purulent complications during the postoperative period in the patients operated on gastrointestinal organs.     

Ciprofloxacin in the treatment of infections in oncology patients

Treatment of infectious complications with ciprofloxacin in 65 patients provided good and satisfactory results in 67.7 and 20.0 per cent of the cases, respectively. The drug was efficient in sepsis, urogenital infections, respiratory infections and postoperative purulent complications. Ciprofloxacin showed a broad antibacterial spectrum. 96.3 per cent of the isolates belonging to aerobic organisms causing purulent inflammatory processes, including those with high antibiotic resistance levels, such as Pseudomonas spp., Proteus spp., Klebsiella tribe and Staphylococcus aureus were sensitive to the drug. In its antibacterial spectrum ciprofloxacin was similar to ofloxacin. The advantage of ciprofloxacin is its possible use not only orally but also intravenously. Adverse reactions to ciprofloxacin were observed in 5 (7.7 per cent) out of the 65 patients. In two cases discontinuation of the drug use was required. The use of ciprofloxacin in treatment of infectious complications in oncological patients is promising.     

Ciprofloxacin and other antimicrobial drugs in the treatment of disseminated peritonitis]

Forty two patients with general peritonitis were treated with ciprofloxacin and combinations of various antimicrobial drugs. Ciprofloxacin had the highest effect on aerobic and anaerobic microbes in the peritoneal cavity which defined the favourable clinical results in all the patients. Moreover, there were observed no disorders in the composition of the normal intestinal microflora which in the end promoted a decrease in the number of the patients with suppuration of the surgical wound.     

Reinfection in brucellosis]

The results of clinical observation on 68 recurrent cases of brucellosis, occurring a long time (3 to 30 years) after the primary disease, are presented. As the recurrent disease developed against an unfavorable premorbid background, a considerable severity in the clinical manifestations of brucellosis was observed.     

Nutrient medium for the isolation of hemocultures from brucellosis patients]

To isolate brucellosis causative agent from the blood of patients against the background of antibiotic therapy the authors used for the first time the medium consisting of aminopeptide, beta-globulin agar with glucose, glycerine, and twin-60. No valuable food products--meat, liver--were required to prepare the medium; by-product of gamma-globulin production being used. With the aid of the suggested medium there was isolated 2.4 times more hemocultures than on the widely used meat-peptone medium. This is attributed to the presence in the medium of human protein, essential amino acids, and blood mineral substances, which, in combination, facilitated adaptation of brucellosis causative agent to the nutrient medium similar to human blood by composition. Economical effect in using the mentioned medium constituted 53.8% annually.     

替加环素与米诺环素治疗布鲁菌病的进展

布鲁菌病是由布鲁菌引起的人畜共患传染性疾病，由带菌动物通过多种途径传染给易感人群，可侵犯人体各器官系统。目前推荐的抗布鲁菌治疗方案为多西环素、利福平、喹诺酮类、氨基糖类等抗菌药物组合的二联或者三联抗菌方案，但治疗无效率和疾病复发率仍较高。替加环素和米诺环素作为四环素类药物，经体外实验证明均可有效抑制布鲁菌，且50%最小抑菌浓度（50% minimal inhibitory concentration，MIC50） 和 90%最小抑菌浓度（90% minimal inhibitory concentration，MIC90）均较低。临床研究亦证实，包含替加环素和米诺环素的联合抗菌方案具有较低的治疗无效率和疾病复发率。因此，替加环素和米诺环素可作为治疗布鲁菌病的候选用药。本文就布鲁菌病传统治疗方案以及替加环素和米诺环素的抗菌效果进行综述。     

Pefloxacin in the treatment of patients with mucoviscidosis]

It was shown that microbial flora isolated from the bronchial secretion of 39 patients with mucoviscidosis in 1999-2001 consisted in one third (32.8%) of S. aureus strains. Evaluation of pefloxacin efficacy in the case of monoinfection and pathogens association revealed potent antistaphylococcal effect of the drug. Positive result was demonstrated in 82.3% cases by the 7th day. Among the side effects dominated arthropathy which disappeared at the period from 3 days to 3 months after drug administration was stopped.     

Antibody neutralization test in brucellosis]

The authors present the results of study of the antibody neutralization test in brucellosis with the use of erythrocytes sensitized with lipopolysaccharide. This test was shown to be highly specific and sensitive in detection of brucellae and brucellosis antigen in pathological material, food and objects of external environment.     

Natural resistance factors in brucellosis]

A higher level of the opsono-cytophagous capacity of the blood and the quantitative content of lysosomal cationic proteins in polymorphonuclear neutrophils in the blood of Fischer rats in comparison with the corresponding characteristics in normal guinea pigs has proved to be conductive to more active elimination of the infective agent from the body of the animals after their infection with brucellosis. The indices characterizing the activity and intensity of the phagocytosis of brucellae by polymorphonuclear neutrophils of the blood in combination with the determination of the amount of cationic proteins in these cells permit the objective characterization of the level of nonspecific resistance to brucellosis.     

Circulating L-lymphocytes in brucellosis patients

The content of L-lymphocytes in patients with different clinical forms of brucellosis has been studied. The degree of a decrease in the level of these cells has been found to depend on the activity of the infectious process and its clinical manifestations in the form of polyarthritis. The severity of the course of acute and subacute brucellosis has been found to produce no essential influence on the level of L-cells. These cells are supposed to participate in the processes of pathogenesis and the elimination of the pathogen in brucellosis.     

Laboratory diagnosis of animal brucellosis]

Brucellosis is still a topical disease both in humans and in animals. The need for a laboratory diagnosis is very important to confirm the disease. The present article reviews the principal techniques used in the laboratory for the diagnosis of brucellosis.     

Analysis of PCR-diagnosis of brucellosis in human]

Polymerase chain reaction (PCR) was used for the diagnosis of brucellosis in humans with different forms of this disease. A high incidence (77.6%) of Brucella infection was revealed in the staff of cattle breeding centers with unfavorable situation with regard to brucellosis. Such a conclusion was made after PCR testing of native human sera. In acute brucellosis of humans amplification of the specific site of brucella DNA in PCR is possible only after extraction of DNA by a procedure adapted for DNA extraction from intact brucella cells. In chronic infection weak amplification of brucella genome DNA fragment was observed in investigation of native sera by the PCR. More expressed amplification product was recorded in PCR with a DNA precipitate from this serum obtained by ethanol precipitation. A still higher level of brucella DNA fragment amplification was observed after DNA extraction from sediment obtained by ethanol precipitation from this serum. These data confirmed the incomplete phagocytosis phenomenon at the early stage of infection, known in brucellosis pathogenesis, and allowed some hypotheses on the pathogenesis of chronic phase of brucellosis infection.     

Imipenem in the treatment of patients with severe surgical infection]

The clinical efficacy and safety of intravenously administered imipenem/cilastatin in the treatment of 45 patients with severe bacterial septicemia due to intra-abdominal abscesses, respiratory and urinary tract as well as skin, soft tissue and bone infections was studied in the prospective and open trial. The in vitro antimicrobial activity of imipenem has been assessed on the basis of 909 bacterial strains isolated from patients treated and non-treated with imipenem/cilastatin. Among them were 526 Gram-negative, 370 Gram-positive aerobic bacteria and 13 Gram-negative anaerobic bacteria (Bacteroides sp.). Pathogen susceptibility to imipenem was determined with a disc-diffusion technique using Merck, Sharp Dohme sensitive discs containing 10 mcg of imipenem. Highly sensitive to imipenem were 96.8% of Gram-negative 82.7% of Gram-positive aerobic bacteria and 100% of Bacteroides sp. All patients, in whom evident foci of infection e.g. intra-abdominal abscesses were discovered, were operated on. The dosage of imipenem/cilastatin ranged from 1.5 to 2.0 g/24 h. Clinical cure and bacteriological elimination was achieved in 39 (86.7%) of patients while 6 (13.3%) showed marked clinical improvement. Before and during therapy, aerobic and anaerobic cultures were taken from accessible sites. All specimens were worked up using conventional bacteriological techniques. Before during and after therapy, samples for hematology, biochemistry and urinanalysis were obtained. Adverse clinical effects were noted in 2 (4.4%) patients. One had nausea and vomiting which were probably related to rapid infusion and disappeared after increasing the administration time, and one had transient diarrhea. In conclusion, imipenem/cilastatin was a well tolerated and effective drug in the treatment of life-threatening surgical infections.     

Sulperazone in the treatment of severe infections in patients with cancer]

For the evaluation of rational sulperazone position in oncological hospital and elaboration of its implementation criteria investigation was performed. The trial included 193 patients (88 patients with injuries, 66 with hospital pneumonia, 39 with urinary track infection). From different clinical material of the patients were isolated 136 straines of Gram-negative bacteria. Suseptibile to sulperazone were 67 per cent of P. aeruginosa, 78-86 per cent of P. vulgaris, Klebsiella and E. coli isolates, 66 [symbol: see text] 60 per cent of Enterobacter and Serratia isolates subsequently. Comparative results of treatment with sulperazone as monotherapy and for combination with aminoglycosides (gentamycin or amicacin) in the case of P. aeruginosa infection demonstrated high sulperazone efficacy not lower than imipenem/cilsatatin and cefepime efficacy in the case of hospital infections treatment at critical care units. Low price of the sulperazone treatment when compared to imipenem/cilastatine is emphasized. Another advantage of sulperazone when compared to cefepime is anaerobic infection treatment--cefepime is administered in combination with metronidazole while sulperazone is used in monotherapy.     

Determination of immunoglobulin E concentrations in the sera of patients with chronic brucellosis

The data on the level of IgE in the sera of 41 patients with chronic brucellosis are presented. The IgE content in the sera was determined by the radioimmunoassay. A 3- to 17-fold increase in the concentration of total IgE was revealed. The increased concentration of IgE correlated with the results of Burnet' allergic test and the indirect leukocytolysis test.     

Dynamics of the humoral immunity indices in patients with subacute brucellosis being treated with levamisole

The dynamics of the main characteristics of humoral immunity in patients with subacute brucellosis, receiving levamisole and placebo, has been studied. Levamisole produced an immunomodulating effect manifested by an increase in the number of B-lymphocytes and a drop in the level of circulating immune complexes. Levamisole did not essentially influence the content of serum immunoglobulins and specific antibodies.     

Ciprofloxacin and antibacterial therapy of respiratory tract infections]

Fluoroquinolones are present considered as an important independent group of chemotherapeutics within the class of quinolones, DNA-gyrase inhibitors characterized by high clinical efficacy and numerous indications, and clinical efficacy and humerous indications, and are known as a serious alternative to other highly efficient broad spectrum antibiotics. Significant clinical experience is accumulated with respect to ciprofloxacin, one of the first agents of the group up to date used clinically. In spite of the negative tendencies in development and distribution of antibiotic resistance, ciprofloxacin remains valid as an alternative drug in the treatment of many infections of various localization. Ciprofloxacin is one of the most useful agents in step-by-step or combined antibacterial therapy. Its us is substantiated by convincing microbiological, pharmacokintic and pharmacoeconomic reasons.