[Aminoglycoside treatment I. Administration of gentamicin once versus three times daily]. / Aminoglykosidbehandling I. Gentamicinbehandling én gang versus tre gange daglig.

Gentamicin is the most commonly used aminoglycoside in Danish hospitals. The aim of this study was to compare two dosage regimens, thrice-a-day (TID) and once-a-day (OD) with regard to efficacy, safety and tissue toxicity. Twenty-three patients were allocated to TID and 26 were allocated to OD gentamicin. Data from patients treated for more than 72 hours were evaluated. Efficacy was assessed by the rate at which body temperature fell to normal. Renal toxicity was judged by an increase in serum creatinine of more than 50 mumol/l and inner ear toxicity was clinically estimated daily during treatment, followed up by audiometry if positive signs occurred. Serum gentamicin was determined daily to estimate the size of next dose. A low frequency of dose adjustments was considered to reflect safety, as well as the absence of renal and inner ear affection. Results showed no significant differences between the two groups regarding efficacy, safety or tissue toxicity. Renal toxicity developed in two patients on TID regime and in one patient on OD regime. No inner ear toxicity was seen. The renal toxicity appeared unpredictably, both early and late in the treatment period and preceded by low or high values serum gentamicin. It is recommended that gentamicin be administered OD for reasons of economy and convenience and that kidney function be monitored daily throughout the treatment period.

[Aminoglycoside treatment II: Dosage regimes at the departments of internal medicine in Denmark]. / Aminoglykosidbehandling II. Dosisregimer på intern-medicinske afdelinger i Danmark.

The aim of this study was to get a general view of the habitual practice of the usage of aminoglycosides in Danish medical departments, regarding choice of drug, dosage regimen and monitoring of drug-related toxicity, as this antimicrobial agent is commonly used in Danish hospitals against severe infections in spite of the potential for nephro- and ototoxicity. The survey, taking place in 1991 and in 1994, showed that gentamicin and netfilmicin were preferred as first choice with an equal frequency in university and county hospital department, whereas in departments in small hospitals gentamicin was preferred twice as often. From 1991 to 1994 the dosage regimen most commonly used had altered from thrice-a-day to once-a-day. Monitoring of serum levels of the drug was performed on all treated patients in fifty-two of the seventy-nine departments questioned. Most of the departments also monitored the kidney function.

[Chlamydia trachomatis in pregnant women in the county of Vestsjaelland. Prevalence, prevention of perinatal transmission and cost-effectiveness of screening]. / Chlamydia trachomatis hos gravide i Vestsjaellands Amt. Proevalens, forebyggelse of perinatal smitte og cost-effektivitet ved screening.

The prevalence of genital Chlamydia trachomatis (CT) in pregnant women and the perinatal transmission after treatment was investigated. An analysis of the cost-effectiveness of introducing a screening program among women at risk of having CT was made. Out of 339 pregnant women 2.9% had cervical CT. CT-positive women were treated with erythromycin. CT-positive women were significantly younger than CT-negative women and the odds ratio (OR) of having CT if nulliparous was 3.35. The CT-prevalence was 6.6% among women younger than 25 years and 1.6% among women 25 years or older (p = 0.0163). OR of having CT if younger than 25 years was 4.3. The young women were significantly younger at sexual début. None of the children of women treated for CT during pregnancy developed neonatal CT-conjunctivitis. The screening of women younger than 25 years was considered to be cost-effective. It is concluded that women younger than 25 years are at risk of having CT. Treatment of CT-positive women with erythromycin during pregnancy seems to be effective in eradicating this microorganism and thus preventing perinatal transmission and neonatal CT-conjunctivitis. It therefore seems rational to screen all pregnant women under the age of 25 years for cervical CT, especially in high risk areas.

Prevalence and antibiotic sensitivity of Danish versus other European bacterial isolates from intensive care and hematology/oncology units.

The prevalence and antibiotic sensitivity patterns of bacteria collected consecutively from medical and surgical intensive care units (ICUs) and from hematology/oncology units in nine hospitals in Denmark were determined and compared to data collected simultaneously in 12 other European countries. Bacterial isolates from 794 Danish patients were tested and compared to 8,625 isolates from European patients. The minimal inhibitory concentrations of eight different antibiotics were determined using a microdilution plate. Similar to findings in European countries, the most common source of bacterial isolates in Danish units was the respiratory tract (49%), followed by blood (18%), urinary tract (14%) and surgical wounds (10%). Staphylococcus aureus was the most prevalent respiratory organism in Danish units, whereas Enterobacteriaceae and Pseudomonas aeruginosa dominated in other countries. In blood, Escherichia coli was most prevalent in Denmark while coagulase-negative staphylococci were predominant in other countries. Urinary tract isolates were dominated by Escherichia coli in both Denmark and the other countries, but Enterococcus faecalis and Pseudomonas aeruginosa were more frequently isolated in the other countries. Staphylococcus aureus was the most frequent wound isolate in Denmark, while Enterobacteriaceae other than Escherichia coli dominated in other European countries. Thus, in Denmark Escherichia coli and Staphylococcus aureus, followed by Pseudomonas aeruginosa and Klebsiella spp. (from ICUs) or Enterococcus spp. and Klebsiella spp. (from hematology/oncology units), are the most prominent pathogens in these units today. Indicator organisms of antibiotic consumption (Pseudomonas aeruginosa and methicillin-resistant coagulase-negative staphylococci and Staphylococcus aureus) were more frequent in other European countries than Denmark. In general the Danish isolates were more sensitive to antibiotics than the European isolates.(ABSTRACT TRUNCATED AT 250 WORDS)

[Urinary tract infections, etiology, diagnosis and treatment with effective antibiotics]. / Urinvejsinfektioner--aetiologi, diagnose og behandling med relevante antibiotika.

Among young, sexually active women, the prevalence of urinary tract infections (UTI) is five per cent, which is 30-50 times higher than among men. The incidence increases with age, and the female: male ratio declines. UTI account for 40 per cent of nosocomial infections. Single dose treatment is to be highly recommended in acute, uncomplicated cases of UTI in adult women, the advantages being satisfactory effect, fewer side effects, reduced development of resistance, and substantial reduction in antibiotic consumption.