Ciprofloxacin in the treatment of patients with brucellosis]

With the aim to estimate the clinical and immunological efficiency of the ciprofloxacin (cifloxinal) 105 patients with acute (51), subacute (19) and chronic (35) brucellosis were studied. Control group (17 patients with acute and 30 patients with chronic brucellosis) have been treated with combination of two antibiotics: doxycycline and rifampicin. Ciprofloxacin in a dose 500 mg bid within 14 days in acute stage and 20 days in chronic stage of disease essentially reduced duration of local inflammatory processes of brucellosis with simultaneous treatment of the chronic infection focus, provides good proximate and distant outcomes of treatment. Ciprofloxacin can be considered as an alternative drug for the treatment of brucellosis, more effective (clinically and immunologically) than a combination of two antibiotics: doxycycline and rifampicin.     

Antibacterial therapy in disseminated purulent peritonitis

Analysis of 156 records relating to patients at the age of 15 to 85 years with extended purulent peritonitis of the surgical and gynecological genesis (the toxic phase, VI category ASA) showed that combination of programmed sanitation laparotomy and intensive antibacterial therapy performed as short-term courses before, during and after the operation with an account of the information on the nature of the microbial associations and antibioticograms was an efficient procedure in treatment of severe peritonitis. It was indicated in treatment of patients with polyorgan deficiency. When the surgical treatment was adequate early antibiotic therapy allowed to decrease the number and intensity of postoperative complications: the frequency of abscessing in the abdominal cavity and formation of intestinal fistulas lowered 2 and 1.5 times respectively. Such a decrease was also observed in asthenic patients with lowered protective reactions to development of new infectious foci in the abdominal cavity complicating the peritonitis process. It was also possible to prevent with that procedure the infection generalization and development of peritoneal sepsis. With application of the procedure to such patients (20 per cent) lethality lowered 2-fold.     

Efficacy of moxifloxacin in the treatment of secondary peritonitis]

Moxifloxacin efficacy was studied in a prospective open controlled incomparable surveillance of 22 patients at the age of 24 to 78 years (the average of 56.6 +/- 15.9 years old) with extended secondary peritonitis that developed before the hospitalization or not later than 48 hours after the hospitalization. Moxifloxacin (Avelox) was used in a dose of 400 mg every 24 hours at first intravenously as infusions and then orally in the same dose. The abdominal infection was severe (APACHE II of 6 to 12, the average of 8.0 +/- 2.2), in 6 (27.3%) patients signs of severe sepsis with polyorganic insufficiency were observed. The intravenous therapy was used for 3 to 7 days (the average of 3.91 +/- 0.92 days) and the oral therapy was used for 2 to 7 days (the average of 4.50 + 1.37 days). The total time of the treatment was 7 to 12 days (the average of 8.45 +/- 1.53 days). The recovery was recorded in 20 out of the 22 patients (90.9%), disappearance of the main signs of peritonitis being observed within 3-5 days of the treatment. Before the treatment 34 microbial strains were isolated. The most frequent pathogens were E.coli (35.4%) and Enterococcus faecalis (20.6%). In the etiological structure of the community-acquired peritonitis gramnegative enterobacteria prevailed (65%). All the isolates (except 1 strain of E. faecalis) were susceptible to moxifloxacin. The pathogen eradication was stated in 17 out of 18 patients (94.4%). Moderate adverse reactions were observed in 3 patients. Moxifloxacin evidently showed high clinical and bacteriological efficacies in the hospitalized patients with complicated intraabdominal infection including severe abdominal sepsis with the syndrome of polyorganic insufficiency. It can be used for monotherapy of patients with secondary extended peritonitis.     

Sensitivity of microflora isolated in the process of preparing solizyme to antimicrobial drugs]

Microorganisms isolated from intermediate products of microbial lipase (solysime) and auxiliary raw materials, reagents and water used in the production of the enzyme belonged to diverse taxonomic groups. They were mainly susceptible to antibiotics (aminoglycosides, rifampicin, chloramphenicol and others) as well as to antiseptics and chemotherapeutics. However, certain isolates were moderately resistant to some of the antimicrobial agents (they were more frequent among Pseudomonas spp.). The bacteriostatic action of many of the drugs was more pronounced than the bactericidal one. It was especially evident after increasing of the microbial load (from 10(5) to 10(8) CFU/ml). At a temperature of 10 degrees C against 37 degrees C the susceptibility of the cultures to the bactericidal action of the drugs usually decreased.     

The treatment of infectious diseases: advances in the use of antimicrobial drugs

Twenty-eight patients with pulmonary tuberculosis in a small, tax-supported sanatorium were treated by primary pulmonary resection. In a comparison of results with those obtained in the same sanatorium by thoracoplasty and extrapleural pneumothorax, it was noted that in general the patients who had resection had earlier conversion of sputum to "negative" and had a shorter stay in hospital. Complications were not of sufficient frequency to contraindicate use of resection in cases in which there was doubt that thoracoplasty would be effective. The cost of hospitalization for surgical treatment and postoperative care was considerably less when resection was done than it was for either three-stage or two-stage thoracoplasty.     

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.     

A cassette micromethod of determining the sensitivity of anaerobic microorganisms to antimicrobial drugs]

A micromethod based on the use of plates with wells and microquantities of microbial suspensions is described. It provides determination of MICs of antibacterial drugs and sensitivity of clinical strains of anaerobes of 2 or 3 species predominating in pathological materials as well as to preliminarily identify some anaerobic bacteria by their antibiotic sensitivity.     

Efficacy of various antimicrobial agents in the treatment of epidemic typhoid fever]

During superepidemic of a typhoid fever in Tadjikistan the efficiency of application in clinics and of 14 antimicrobial agents representing almost all basic chemical classes was investigated. Remarkable variation of frequency and type of S. typhi resistance to these preparations up to epidemic and especially in its process was demonstrated. The absence of absolute (100%) efficacy of the investigated agents in vivo and in vitro was shown. The reasons of low efficacy of etiotropic treatment of the patients with typhoid fever are analysed.     

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.     

Inotropic drugs in treatment of heart failure--advantages and adverse reactions]

Mechanism of action, hemodynamic effects, efficacy of both shortterm and chronic administration of available inotropic drugs are discussed. An emphasis is on the possible mechanism of detrimental sequelae of the chronic inotropic stimulation of the failing heart.     

In vitro antimicrobial activity of propolis and synergism between propolis and antimicrobial drugs

The aim of this study was to investigate antimicrobial properties of ethanolic extract of 13 propolis (EEP) samples from different regions of Serbia against 39 microorganisms (14 resistant or multiresistant to antibiotics), and to determine synergistic activity between antimicrobials and propolis. Antimicrobial activity of propolis samples was evaluated by agar diffusion and agar dilution method. The synergistic action of propolis with antimicrobial drugs was assayed by the disc diffusion method on agar containing subinhibitory concentrations of propolis. Obtained results indicate that EEP, irrespectively of microbial resistance to antibiotics, showed significant antimicrobial activities against Gram-positive bacteria (MIC 0.078%–1.25% of EEP) and yeasts (0.16%–1.25%), while Gram-negative bacteria were less susceptible (1.25&%ndash;>5%). Enterococcus faecalis was the most resistant Gram-positive bacterium, Salmonella spp. the most resistant Gram-negative bacteria, and Candida albicans the most resistant yeast. EEP showed synergism with selected antibiotics, and displayed ability to enhance the activities of antifungals. The shown antimicrobial potential of propolis alone or in combination with certain antibiotics and antifungals is of potential medical interest.     

Microbial transformations of antimicrobial quinolones and related drugs

The quinolones are an important group of synthetic antimicrobial drugs used for treating bacterial diseases of humans and animals. Microorganisms transform antimicrobial quinolones (including fluoroquinolones) and the pharmacologically related naphthyridones, pyranoacridones, and cinnolones to a variety of metabolites. The biotransformation processes involve hydroxylation of methyl groups; hydroxylation of aliphatic and aromatic rings; oxidation of alcohols and amines; reduction of carboxyl groups; removal of methyl, carboxyl, fluoro, and cyano groups; addition of formyl, acetyl, nitrosyl, and cyclopentenone groups; and cleavage of aliphatic and aromatic rings. Most of these reactions greatly reduce or eliminate the antimicrobial activity of the quinolones.