Evaluation of the effectiveness of antibacterial therapy

It is recommended to estimate the clinical effect of antibacterial therapy in patients with different purulent inflammatory complications with an account of the data on both the clinical and bacteriological examinations. The full affect consisted in disappearance of the clinical signs and complete bacteriological sanation of the purulent inflammatory foci. The partial effect was shown by a marked decrease in the clinical manifestations without complete bacteriological sanation of the foci. The ill effect was evidenced by clinical picture having no time course and no favourable time course in bacteriological tests. No effect was indicated by deterioration of the clinical picture and no favourable time course in the bacteriological tests.     

Ways of increasing the effectiveness of chemotherapy of urinary tract infection]

Efficacy of blood UV irradiation (BUVI) followed by its reinfusion to the patient in combination with antibacterial therapy was studied in patients with acute and chronic pyelonephritis and its purulent septic complications. The BUVI was used when the antibacterial drugs failed to be sufficiently efficient and the clinical process of the infection was severe. The kinetics of ferritin, transferrin, alpha 2-macroglobulin, beta 2-microglobulin and haptoglobulin in the blood serum was investigated as a criterion of treatment efficacy. It was shown that the BUVI markedly increased the chemotherapy efficacy. The observed regularities of the changes in the serum antigenic spectrum can be used as a basis for the control of treatment efficacy.     

Antibiotic sensitivity of pneumonia pathogens in newborns and problems of antibacterial therapy of the pathologic process]

The results of the bacteriological investigation of the secretion from the trachea, large bronchi and fauces of 36 newborns (including 27 preterms) with severe pneumonia were analyzed. 20 of them were born of women with complicating somatic, obstetric and gynecologic histories: candidiasis, herpes genitalis, chronic endometritis, adnexitis or chronic pyelonephritis that could be the risk of the fetus intranatal infection. During the acute period of pneumonia in the newborns within the first 4-8 days of life mainly Pseudomonas aeruginosa was isolated (51.3 per cent), Staphylococcus epidermidis, S. haemolyticus and Enterococcus faecalis were less frequent (18.9, 8.1 and 5.4 per cent, respectively). Klebsiella pneumoniae, Streptococcus anhaemolyticus and other organisms were extremely rare. On the whole the gramnegative microflora predominated. The study of the antibiotic susceptibility showed that the majority of the P. aeruginosa isolates were susceptible to amikacin and polymyxin B, the isolates susceptible to ceftazidime were less frequent, 20-25 per cent of the isolates were susceptible to ciprofloxacin, cefoperazone and imipenem and practically no isolates were susceptible to gentamicin. The S.epidermidis isolates were susceptible to rifampicin and vancomycin and in rare cases to fusidin and amikacin and resistant to oxacillin. When the treatment course was more than 15 days, the isolates proved to be susceptible to 1/3 of the presently available antibiotics. Because of the host low protective forces, peculiarities of the infection pathways and high frequency of the resistant strains it is valid to include netilmicin, imipenem, cefoperazone and ceftriaxone to the complex therapy of the newborns along with the substitution immunotherapy.     

Ways of increasing the efficacy of antibiotic therapy in young children with severe forms of acute pneumonia]

Examination of 136 children with the severe form of acute pneumonia treated in a resuscitation unit revealed a marked suppression of the immunity and lowered antibiotic sensitivity of the bacterial microflora isolated from the respiratory tracts. The patients were previously treated with antibiotics of 2 to 5 families. Auto-blood irradiated with X-rays without the host was transfused to 72 children (group 1) with immunomodulating purposes. 64 children (group 2) were treated with the same purposes with eleuterococcus, pentoxyl and methyluracil. After transfusion of the auto-blood irradiated with x-rays without the host there was an increase in the antibiotic sensitivity of the bacterial flora along with a marked and rapid improvement of the immunity status. The severe state was alleviated earlier in the patients of group 1. The inflammatory lesions in the lungs of the group 1 patients were arrested sooner and the patients were discharged from the hospital 11 days earlier than the children treated with the routine immunomodulators.     

Rapid evaluation of the effectiveness of antibacterial drugs in experimental tularemia

Rapid estimation of the protective effect of antibacterial drugs on Fransiella tularensis for not more than 2 days was shown possible in experiments on albino mice infected with tularemia. High efficacy of aminoglycosides (kanamycin, gentamicin, streptomycin, amikacin, netilmicin, tobramycin, sagamycin, ribostamycin and sisomicin), tetracyclines (tetracycline, doxycycline, minocycline and methacycline), rifampicin, phosphomycin and oxolinic acid was determined with the recommended rapid method. Amoxycillin, ampicillin, piperacillin, carbenicillin, erythromycin, levomycetin, cefradine, cefmetazole, cefatrizine, cefoxitin, cefsulodin and bactrim (biseptol) proved to be inefficient against the tularemia causative agent.     

Netilmicin in the complex therapy of pneumonia in newborns]

Clinical efficacy of netilmicin was evaluated at 22 newborns (body weight from 1000 to 3600 g, delivery on pregnancy period from 28 to 41 weeks) with pneumonia caused by artificial pulmonary ventilation. Pneumonia was moderate at 13 patients and severe at 9 patients. Microorganisms isolated from tracheobronchial aspirates were mainly (in 19 cases of 22) susceptible to netilmicin. The usage of netilmicin in combination with cephalosporins was effective at the main part of the newborns and resulted with the full recovery of 11 newborns (all the patients with moderate pneumonia), in 9 cases improvement was registered (including 7 newborns with severe pneumonia). Newborns with severe pneumonia had a slow pathogens elimination.     

Experimental study of the effectiveness of antibacterial preparations in treating dysentery]

It was found that for successful elaboration of effective schemes for the use of antibacterial drugs in treatment of dysentery it was necessary to exploit various experimental models providing consideration of the drug toxicity and effect on the extra- and intracellular growth of the bacteria in addition to the other factors. The administration of enteroceptol for 3 days followed by furazolidon showed the best therapeutic effect in the treatment of guinea pigs with Shigella keratoconjunctivitis and Syrian hamsters with dysentery. The above drugs had low toxicity which was shown in the experiments with Hep-2 cell cultures. It was concluded that the use of the drugs with different modes of action was advisable in treatment of dysentery.     

Use of vilozen and ketotifen combination for increasing the effectiveness and prevention of complications of antibiotic therapy of streptococcal infections]

The clinical efficacy of a vilozen and ketotifen (zaditen) combination in the treatment of streptococcal infections along with the routine therapy was studied. The use of the combination was shown advisable in the complex therapy and prevention of relapses in patients with streptococcal infections. The combined pharmacotherapy promoted better clinical indices, normalization of the immune status and a reduction in the incidence of allergic reactions to antibiotics and a decrease in sensitization to bacterial allergens.     

A rapid method of evaluation of the effectiveness of antibacterial drugs]

Efficacy of antibiotics in the treatment of experimental tularemia was studied comparatively on various biological models. It was shown that the antibiotics which proved active against the tularemia microbe in albino mice when studied by the rapid and routine methods were highly efficient in the treatment and prevention of experimental tularemia in rabbits and baboons (hamadryas). The experiments showed basic possibilities to perform rapid estimation (for at least 2 days) of drug efficacy in experimental glanders and melioidosis in golden hamsters. The rapid method developed by the authors was recommended for the use in primary estimation of the efficacy of new drugs in the treatment of tularemia, glanders and melioidosis.     

Value of determining the spectrum of blood serum fatty acids in evaluating increasing the effectiveness of antibiotic therapy of dysentery in children with prodigiozan and ephedrine

One hundred and ninety one children with acute Sonne and Flexner dysentery were observed with respect to the disease process, immunity indices and blood serum fatty acid spectrum. 104 children were treated with monomycin alone and 87 children were treated with the antibiotic in combination with prodigiozan and ephedrine as immunostimulators. It was shown that the recovery terms in the patients treated with the use of the immunostimulators decreased as compared to the patients treated with the antibiotic alone. The fatty acid spectrum in the children treated with the use of the immunostimulators differed from that in the children treated without them by low levels of fatty acids of the C12:0 to C18:1 composition.